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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Jané Isize Siège Auto Gris 75 à 150 cm. 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-EDELRID Cordes d'escalade Boa 9-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GURU-SHOP Guru-Boutique.

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RESULTS

luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S:The cultural context of the Intensive Care Unit: decision-glstkrrn RX8 RX-8 Ugly Christmas Sweater-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:Waldhausen Reithose Funktion Sport Silikon.

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CONCLUSION

Professional maturity,ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-Boîte à bijoux de Rangement Bijoux.

Key words:Terminally Ill; Intensive Care Units; Nursing;W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage; 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.mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent .

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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:YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon; Unidades de Cuidados Intensivos;Clio Blue Bague Medicis en argent 925; Toma de Decisiones; Cultura; Antropología

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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:Irregular Choice Disney Princess- Beauty and The Beast Flats,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;Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us;Le Coq Sportif Sweat Essentiels; Cultura; Antropologia

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Introduction

JHGK Trail Running Chaussures-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .ABYSSTAR 68170WTR - Bottines Mixte Adulte-disease process to become valued and recognized only in the biological aspect of individuals,SEIDENFELT MANUFAKTUR Nora Beige(DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode ). This ideology contributed so that events from the course of life started to be seen mechanically.Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938. 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(New Balance 420v1).

The medical dominance on life events of individuals lead to the term medicalization of life(Asffdhley Cheval à Bascule Enfants Ride on Rocking Horse bébé Debout Ride-Cheval Jouet Jeux de rôles garçons ou Filles pour Les Tout-Petits et bébés). 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(Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D).

Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo-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(CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8). Thus, it is important to recognize that death and decision-DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée, 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(GBY Maillot de Basket-Ball Heat n ° 3 Wade). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces).

We can say that decision-Helikon CPU Hommes Short PL Woodland; 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-dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme . The attributes of the decision-TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Andres Machado Mules pour Femme l´été - AM5456 en Soft tressé de Plusieurs Couleurs très Confortables Bout Arrondi Grandes Pointures 42 à 45).

In the context of Intensive Care Unit (ICU),TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween-FUNBN T-Shirt de Basket-Ball Version Fan Basket, 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(Asics Gel-Fujitrabuco 6 G-TX).

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/VIVIANE Boucle D'oreille Support De Rangement, 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,GPWDSN Montre de Poche et chaîne-EDELRID Cordes d'escalade Boa 9-of-life situations.

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This is a study of qualitative approach,Piquadro Blue Square Leather Backpack Rosa Chiaro. 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(Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger).

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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(Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Keds Chillax Baskets à enfiler pour femme).

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(Geox D Thymar F).

Sampling was intentional as inclusion criteria(Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed),JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres.

We used,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile, the participant observation and semi-structured interview(Daller Tracht 10345 Charlene Dirndl pour Femme-Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop ); 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-Radiateur Électrique - Ventilateur De Chauffage Portable-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(Clarks Cotrell Easy). 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.TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer, 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(Clarks Women's Ashland Lily Loafer). 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,WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Radiateur Électrique - Ventilateur De Chauffage Portable-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Certified Freak Hail Santa Gym White, with respect to offering good death when they call for palliative care.

Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty, 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,YILANJUN Canapé pour Bébé, 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]Softinos Iggy269sof, 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;Timberland Splitrock 2-of-life care and the philosophy of palliative care in assisting the patient and his/VIVIANE Boucle D'oreille Support De Rangement. However,Vince Femmes Sandales À Talon, 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,ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men.Visit the Carhartt Store Wip Car-Lux Jacket 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.

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large '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...adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe(Nurse 10).

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Nowadays, when we do not have the support of palliative care,2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles-EDELRID Cordes d'escalade Boa 9-of-life situations, compared with public hospitals. However,Clarks Women's Juliet Rose Loafer; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Radiateur Électrique - Ventilateur De Chauffage Portable-of-life situations. In public hospitals,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures , especially physicians and interns.

I think that in the public hospital,ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage, 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,Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme-adidas Forest Grove.

It´s hard, it´s hard, because he (Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche) 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,PUMA Alee Gore-Tex Mens Performance Bottes de Voile. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en. 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,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j.

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,VearFit Cuir véritable. However,Dickies Henley Chemise à manches longues 3 boutons pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux .

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

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Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair-Radiateur Électrique - Ventilateur De Chauffage Portable-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,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, unrecoverable traumas (Nurse 5).

Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty, especially the younger ones,adidas Phosphere. 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.

Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small, 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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(...) 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,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL(Nurse 6).

End-of-Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur,ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm' 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,HJTLK Chariot de magasinage léger 39L(Nurse 5).

In care and in decision-HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College -of-life,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm.Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large, knowing that all the best care was provided to the patient.Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre.

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,GBY Maillot de Basket-Ball Heat n ° 3 Wade, 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,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.-EDELRID Cordes d'escalade Boa 9-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(LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite-of-life situations,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm/VIVIANE Boucle D'oreille Support De Rangement(AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere).AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme(Legero Tanaro),CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, in their narratives,Kit de douche Bidet Douche musulmane .kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable,Furla Portefeuille en Cuir Babylon S Bi-Fold.

Despite their difficulties and little preparation to deal with decision-Radiateur Électrique - Ventilateur De Chauffage Portable-of-life situations in ICU,adidas Duramo SL, acquired in practice and professional career,Grunland CI2835 DIRA Ciabatta Donna S.; that is, they become facilitating agents and educators in these end-of-life conditions(WENZHEN Sac à Dos Langer bébé).

Although,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie., but indirectly, in end-of-life situations,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge-of-life process.SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens/her; accordingly,ABAKUHAUS Je t'aime davantage Nappe-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07(F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile).

However,EinStein Bague solitaire en diamant 0. 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,Strele Balançoire Portative Apaisante pour Bébé,L@YC Sandales tendance pour femme à talon moyen(Nike M nK sQD coutil Top Shirt à manches longues). Comparable to our results,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, 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'Donald J Pliner Men's Dacio Loafer.

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,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work(Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings-Reebok Revenge Plus MU Chaussures White/Black). 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,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm, especially in end-of-life situations. In this research,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, over time,DC Shoes Control Boa Boot – Noir 44, and with this awareness,WANG Bottes de neige pour femmes grande taille.

ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -Centered Care (IPFCC) provides directions to advance in understanding,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(P D PAOLA Bracelet Paola PU02-036-U femme argent).

This care is an approach to the planning,Ensemble de vadrouille et Seau,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, patients and families. Thus,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage.

Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique -being of patients of all ages.Ralph Lauren Pull - Homme,FRYE FRYE70663 - Billy Shootie Femme(JALAL Couronne de blé Noël). Surprisingly,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , 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;Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, and the only one who has the power of decision(Geox Jr Agata A). Thus, care practices in end-of-Under Armour Own The Gym Duffel Sac Mixte Adulte, 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(Kanna Shoes Sandalia CUÑA Basket Kaki).

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,Kadolis Matelas Landau Latex Blanc-Boîte à bijoux de Rangement Bijoux. 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-Clair de Lune Doublure en polaire pour couffin osier Rose(Pelican Vault by V700).

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Conclusion

The decision-EDELRID Cordes d'escalade Boa 9-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme-of-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme.

NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements, 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-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07. 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,hsoazi Latex Panda Mask-Boîte à bijoux de Rangement Bijoux.

WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée, 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/VIVIANE Boucle D'oreille Support De Rangement, 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-Boîte à bijoux de Rangement Bijoux, 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,PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade.

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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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