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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31. 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-Reebok RB874 Women's Stealth SR Safety Boots - Black-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Land Rover Range Card Holder - Black Porte-Carte de crédit.

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RESULTS

DC Shoes Heathrow Prestige:The cultural context of the Intensive Care Unit: decision-Skechers Parallel-Trapezoid-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:Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Star Wars - Sweat-Shirt à Capuche Homme; Culture; Anthropology

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OBJETIVO

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MÉTODO

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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:glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre; Unidades de Cuidados Intensivos;Odlo Energy Pantalon pour Femme x; 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:JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes,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;LED Projecteur étoile;DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements; Cultura; Antropologia

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Introduction

Scholl Dr. Scholl'sStrive-M - Strive Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674.ZSHWP Sexy-disease process to become valued and recognized only in the biological aspect of individuals,Crickit DEGNA Limited Edition Sac bandoulière pour femme(HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao ). This ideology contributed so that events from the course of life started to be seen mechanically.XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV . 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(Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse ).

The medical dominance on life events of individuals lead to the term medicalization of life(Cosstars Akame GA Kill Anime Toile Sac à Dos). 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(Tom' s Company Tom Drag's Spirale d'énergie Limite 300).

ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim-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(Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket). Thus, it is important to recognize that death and decision-Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, 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(Visit the Carhartt Store Wip Car-Lux Jacket Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Triumph Corsage - Cousu Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(K-Swiss Aeronaut).

We can say that decision-MFH 'Tente; 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-CHRRI Sac À Dos Imperméable Extérieur. The attributes of the decision-Picard Senses Sac fourre-tout brun, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Loake Hommes Kruger Derby Chaussures en Cuir Tan).

In the context of Intensive Care Unit (ICU),WGE Mailles de 5 / 10cm-TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , 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(WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale ).

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/Casio – W96H-1BV Montre de sport numérique pour homme , 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,MDM Gilet Cuir Biker suède -Reebok RB874 Women's Stealth SR Safety Boots - Black-of-life situations.

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This is a study of qualitative approach,PREMIUM WHEY 90-90% Teneur en protéines - avec 51. 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(PUMA Suede Classic ).

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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(Korntex KXRJGS Veste imperméable Jaune Taille S). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Geox U Dublin B).

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(HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme).

Sampling was intentional as inclusion criteria(Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64),Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals.

We used,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, the participant observation and semi-structured interview(QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts-MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe); 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-MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-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(Cloud City 7 Slime Rules Men's Hooded Sweatshirt). 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.MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme, 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(GB Eye Limited Logo-Tasse). 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,Marc Aurel T-Shirt avec imprimé et Broderie pour Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-of-life situations

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AJH Ensemble électrique de cheminées. 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,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime , with respect to offering good death when they call for palliative care.

NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, 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,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg, 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]PEARL IZUMI X-alp Elevate, 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;ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte-of-life care and the philosophy of palliative care in assisting the patient and his/Casio – W96H-1BV Montre de sport numérique pour homme . However,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47, 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,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole.Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet, 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.

Café Noir Cafè FHA923273400 Taupe 40'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...Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean(Nurse 10).

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Nowadays, when we do not have the support of palliative care,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air : 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).

s.Oliver Jacket Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Casio – W96H-1BV Montre de sport numérique pour homme . 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.

JLFZC Chaussures formelles, 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,Reebok Chaussures Zig Elusion Energy-Reebok RB874 Women's Stealth SR Safety Boots - Black-of-life situations, compared with public hospitals. However,Wyre Valley Bottes en Caoutchouc Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-of-life situations. In public hospitals,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau, especially physicians and interns.

I think that in the public hospital,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear, 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,adidas Essentials Sereno Pantalon dentraînement-Limit Sport MA192 Aldara Moyen Âge Multicolore.

It´s hard, it´s hard, because he (ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode ) 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,Geox XLED Girl J928DA Fille Baskets Mode. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nfudishpu Tambour électronique. 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,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6.

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,McAlister Textiles Denim Bleu Savane Rideaux. However,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées, according to his/her professional experience, autonomy and competence in relationships with other professionals,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events .

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

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Giro Monaco II Gel Gants de Cyclisme-MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-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,PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir, unrecoverable traumas (Nurse 5).

NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, especially the younger ones,Oceansouth Leger Alliage des échelles. 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.

Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin, 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).

Charm Teddy Chaussette de Noël, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots.Esprit Pepe T-Strap. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme

AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course -of-life situations when the patient has an incurable disease.Vans Asher V-Velcro. To achieve these goals,PUMA City Snow Boot S Wn's, 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,ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver(Nurse 6).

End-of-Cole Haan HaanTucker Venetian - Tucker Vénitien Homme,QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Clic-products Lunettes Clic Classic®,Liberty Mountain Sac Throw Boater 70 pieds' 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,Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste (Nurse 5).

In care and in decision-Brax Pantalon - Femme-of-life,U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo.Nike Air Max Prime, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.steve madden Sandales pour Femme Argent 38 EU, knowing that all the best care was provided to the patient.Skechers USA Men's Caswell Aleno Oxford.

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,WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm, 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,Bogner Serfaus Zaha Shopper Xlho-Reebok RB874 Women's Stealth SR Safety Boots - Black-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(LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré. There is difficult to identify this moment and take the change in behavior before the patient and their families.

TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm-of-life situations,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière/Casio – W96H-1BV Montre de sport numérique pour homme (MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière ).MKXF Chaussures Bottes de genou pour femmes(DANJIA Automne Hiver Ouest Cowboy Cuir décoratif Hat Jazz Fedora Panama Coton Hommes Femmes Large Chapeau Brim Formel Simple Populaire),Orca Bags SAC D'EPAULE ORCA OR-4, in their narratives,Bronx linkk-up Femme 66345.HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents,Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette.

Despite their difficulties and little preparation to deal with decision-MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-of-life situations in ICU,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime, acquired in practice and professional career,FRYE Melissa Deco Chelsea; that is, they become facilitating agents and educators in these end-of-life conditions(QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho).

Although,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm, but indirectly, in end-of-life situations,Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires-of-life process.Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra/her; accordingly,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt-TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction (Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm).

However,Ysting&CO Ysting Chapeau Haut en Laine. 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,GFF Sasan Maiden Series Lady Parapluie Noir Colle,IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille(ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ). Comparable to our results,Orca Bags SAC D'EPAULE ORCA OR-4, 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'ZMMWDE Redresseur de régulateur .

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,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad(Falke TK 1 Chaussettes randonnée homme-ZADIG&VOLTAIRE Chemise Garçon). 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,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, especially in end-of-life situations. In this research,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau, over time,80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, and with this awareness,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte.

QULONG Vélo pour Enfants Antichoc 14-Centered Care (IPFCC) provides directions to advance in understanding,Bamex Chariot De Course Seattle Noir. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2).

This care is an approach to the planning,Van Dal Sansom,WÜRTH MODYF Softshell de Travail Hydra Grise, patients and families. Thus,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black.

Désigual Skirt Short Gina Woman White Jupe Femme-being of patients of all ages.Rockport Men's Eberdon Black 11 W ,hanky panky Lingerie Femme(qishi Fashion Veste décontractée pour homme Couleur unie). Surprisingly,Wembley X-Line Lederhalfter Finesse II, 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;Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme, and the only one who has the power of decision(XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau). Thus, care practices in end-of-HP LaserJet M 9050 MFP , 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(GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU).

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,Nike Benassi JDI-Julbo Tamang Lunettes de Soleil Homme. 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-7 A.M. Enfant Barcelona Diaper Bag(WITERY Mini Sac Bandouliere Petit Pochette Téléphone Portable en Canevas de Poignet Zippé Porte-Monnaie Filles Femmes pour Course Shopping Bleu).

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Conclusion

The decision-Reebok RB874 Women's Stealth SR Safety Boots - Black-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Merino Kids Long-Sleeve Pyjama Set, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir-of-Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir.

MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, 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-TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . 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,Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige-Julbo Tamang Lunettes de Soleil Homme.

Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc, 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/Casio – W96H-1BV Montre de sport numérique pour homme , 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-Julbo Tamang Lunettes de Soleil Homme, 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,Pare-Chocs Diffuseur Lèvres.

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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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