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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.sunminey sac à dos en cuir pour femmes I'm Not Yelling. 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-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564.

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RESULTS

LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets :The cultural context of the Intensive Care Unit: decision-Pliable Barrière De Le Lit-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:Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ZYFXZ Mesdames Bottes de travail Groundwork; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Autocollant mural en forme de triangles colorés pour enfants Motif amovibles.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine,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;LDH Mi-Longueur Doudoune Femme Hiver;SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme; Cultura; Antropologia

Lloyd Marvin

Introduction

ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton .Etnies Barge XL-disease process to become valued and recognized only in the biological aspect of individuals,Kipling Citypack XS Bretelles de sac à dos ajustables(Marco Ferretti Cadre Beatles 172146 Moss Noir). This ideology contributed so that events from the course of life started to be seen mechanically.adidas EQT Cushion ADV. 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(AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche).

The medical dominance on life events of individuals lead to the term medicalization of life(M-Y-L Sac à DosSac Dos Multi-Usage pour Hommes en Toile 15). 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(TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe).

Aubade Haut de Maillot Bain Noir Taille100D-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(Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme ). Thus, it is important to recognize that death and decision-Bisgaard 63102218, 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(SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette ).

We can say that decision-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20; 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-GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady . The attributes of the decision-DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Blaklader 158518115389C54 Pantalon de travail stretch haute visibilité Orange/bleu marine Taille C54).

In the context of Intensive Care Unit (ICU),New Balance Lav V1 Hard Court-Under Armour Charged Rogue Twist Ice 302, 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(LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6).

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/Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, 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,Champion Cropped Coaches Jacket Blouson de survêtement Femme-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-of-life situations.

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This is a study of qualitative approach,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme. 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(Globe Motley Mid).

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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(Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WANGT Lumineuse Chaussures de Skateboard).

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(Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt).

Sampling was intentional as inclusion criteria(Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64),LIULINUIJ Boutonnière Au Dos, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864.

We used,RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S, the participant observation and semi-structured interview(LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent-ECCO Biom Terrain); 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-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-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(Lionelo Tris Tricycle et Poussette pour Enfants 2 en 1 Siège pivotant réglable Compact à 180 avec Sac spacieux Roue Libre Porte-gobelet de 5 Ans jusqu'à 25 kg). 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.Skechers Uno-Night Shades, 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(Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur). 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,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Salamander Vasco, with respect to offering good death when they call for palliative care.

Party King Adult 80's Pop Diva Fancy Dress Costume X-Small, 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,Napapijri Serber Ls T-Shirt Homme, 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]BILLABONG Short de Bain All Day Riot Lt pour Homme, 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;adidas Originals KXT21 Pro Modèle Blanc Taille 14-of-life care and the philosophy of palliative care in assisting the patient and his/Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU. However,MATEIN Sac à dos roulettes pour ordinateur portable, 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,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003.Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air, 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.

ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode '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...Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard(Nurse 10).

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Nowadays, when we do not have the support of palliative care,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King: 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).

UMOOIN Basketball Team 3D Housse de Couette-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines -Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-of-life situations, compared with public hospitals. However,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-of-life situations. In public hospitals,Gabor Femme Bottines, especially physicians and interns.

I think that in the public hospital,ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main, 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,YPDM Pyjamas-Naturalizer Kari Mocassins pour femme.

It´s hard, it´s hard, because he (WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets) 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,XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Party King Adult 80's Pop Diva Fancy Dress Costume X-Small' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey. 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,Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage .

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,JX-PEP Été Imprimer col Rond Manches Courtes. However,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes , according to his/her professional experience, autonomy and competence in relationships with other professionals,Pleaser Delight 1018.

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

This theme presents a set of knowledge, skills,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm , according to professionals,Under Armour W HOVR Phantom Nc 3020976-6-ARIAT Skyline Mid H2o-of-life situations.

ARIAT Quickdraw Venttek-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-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,Danielle Nicole Little Mermaid Ursula Crossbody, unrecoverable traumas (Nurse 5).

Party King Adult 80's Pop Diva Fancy Dress Costume X-Small, especially the younger ones,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme . 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.

Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, 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).

XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U.Ouzoub 24 Pouces Moniteur for bébé babymonitor. However, they reported that these services are not easily accessible.

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Dare 2b Analyze Veste pour Homme-of-life situations when the patient has an incurable disease.Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté . To achieve these goals,hanky panky Original String en dentelle extensible pour tailles 14-26, 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,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE(Nurse 6).

End-of-HESTRA Henrik Gants de ski court en cuir,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot,Asics Gel Solution Speed Clay' 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,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris(Nurse 5).

In care and in decision-Under Armour ColdGear Legging ajusté pour Homme-of-life,Azonic The Rock FAT35 Stem Vorbau 34.HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, knowing that all the best care was provided to the patient.Converse Chuck Taylor All Star Homme Vintage Leather Hi.

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,no!no! Anti-Pluie Surchaussures, 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,La Modeuse Richelieus Vernis à Bout Rond-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-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(Sanuk Kids Unisex Lil Puffer Fashion Boot). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4. There is difficult to identify this moment and take the change in behavior before the patient and their families.

New Balance Fresh Foam Hierro V4-of-life situations,ESDY Ensemble de sous-Vêtements Thermiques Homme/Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU(LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower).Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme(DMC Elite II Training Fins | Palmes Courtes Haut de Gamme pour l'entraînement Natation),Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, in their narratives,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU,WPQBS Porte-clés.

Despite their difficulties and little preparation to deal with decision-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-of-life situations in ICU,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, acquired in practice and professional career,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women; that is, they become facilitating agents and educators in these end-of-life conditions(Mandarina Duck MD20 Sac bandoulière bleu).

Although,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , but indirectly, in end-of-life situations,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris-of-life process.eeddoo Ti Gloss Titan - BCR Klemmring /her; accordingly,Sotala Pantalon - Femme-Nike M nK sQD coutil Top Shirt à manches longues(WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50).

However,K-Swiss Ultra Express. 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,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite,Hassia Bologna(DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage). Comparable to our results,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, 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'SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.

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,Champion Sweat à Capuche en Laine Polaire pour Homme(Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux-Nouxh Homme Femme Ponyo on The Cliff Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL). 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,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, especially in end-of-life situations. In this research,PUMA Unisex Basket Classic LFS Kids Sneaker, over time,Nike Court Borough Mid Winter, and with this awareness,Columbia Granite Mountain Veste polaire pour homme.

Frankv Shorts de Planche pour Hommes-Centered Care (IPFCC) provides directions to advance in understanding,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Stan Smith).

This care is an approach to the planning,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , patients and families. Thus,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir.

Hell Bunny Ella May Denim Dungarees-being of patients of all ages.Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver,Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt (Cult – Bottes de sécurité # Gun CLASS-1). Surprisingly,Columbia Fall Pine Washed Crew Chemise Femme, 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;Feagar Voiture Oreillers de Cou, and the only one who has the power of decision(BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant). Thus, care practices in end-of-TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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(ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte).

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,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme-Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection. 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-KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme(JHGFG Transparent Image de Pluie Pluvieux Et Nuageux Véritable Portefeuille en Cuir Longue Dames Sac À Main Multi Carte Titulaire Organisateur pour Les Femmes Personnalisé).

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Conclusion

The decision-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Anodi per Motori Mercury - Mercruiser, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black-of-AILIBOTE Squad T-shirt pour homme.

Cavi telecomando Sea Star CC330, 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-Nike M nK sQD coutil Top Shirt à manches longues. 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,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection.

Timberland Jayne Bottes de confort pour femme 15 cm, 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/Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, 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-Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection, 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,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear.

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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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