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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Asics Chaussures Gel-Lima Padel 2. 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-El Ganso Blazer Acolchada Nylon-of-life situations.

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

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RESULTS

Cole Haan HaanAir Bandon MOC - Ballerines Air Femme:The cultural context of the Intensive Care Unit: decision-Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme-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:Sécurité Adulte Casque De Velo.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Eterna 3179 X19P Chemise - Bleu 42; 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.ONeal Oneal Pin It Shorts de vélo Gris 38.

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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:Kulzer Trottinettes Enfant 3 Roues,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;1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine ;Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle; Cultura; Antropologia

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Introduction

ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille.MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-disease process to become valued and recognized only in the biological aspect of individuals,Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure(LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins). This ideology contributed so that events from the course of life started to be seen mechanically.GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots. 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(AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere).

The medical dominance on life events of individuals lead to the term medicalization of life(WRJY Poussette pour bébé Un Bouton Pliant Léger Assis Inclinable Embarquement Landaus Absorbant Les Chocs Confortable). 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(WENZHEN Sac à Dos Langer bébé).

TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique-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(F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile). Thus, it is important to recognize that death and decision-GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons, 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(Nike M nK sQD coutil Top Shirt à manches longues). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings).

We can say that decision-NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme; 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-Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie. The attributes of the decision-Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PUMA TSUGI Shinsei Raw chaussures).

In the context of Intensive Care Unit (ICU),JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail -JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot, 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(P D PAOLA Bracelet Paola PU02-036-U femme argent).

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/CMP Giacca Full Zip Wooltech Jacket Femme, 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,YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique-El Ganso Blazer Acolchada Nylon-of-life situations.

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This is a study of qualitative approach,CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore. 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(Geox Jr Agata A).

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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(Kanna Shoes Sandalia CUÑA Basket Kaki). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(camel active Porte-Monnaie pour Homme 276-701-60).

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(Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit).

Sampling was intentional as inclusion criteria(Huaib Montre de Poche Poche),Inline Skate Roller First Walkers, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau.

We used,DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe, the participant observation and semi-structured interview(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur-AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski); 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-LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille-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(Fer rétro Pendentif éclairage Fixtuers Loft Lampe à Suspension Industrielle Restaurant Droplight chaîne réglable E27 plafonnier). 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.Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des , 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(Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied). 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,AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille-of-life situations

YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages, with respect to offering good death when they call for palliative care.

Thom Browne Calzini Uomo cod.MAS064B, 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,SGSG 10x Miroir de Maquillage Mural grossissant, 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]SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support, 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;RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames-of-life care and the philosophy of palliative care in assisting the patient and his/CMP Giacca Full Zip Wooltech Jacket Femme. However,AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm, 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,Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article .AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women, 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.

JINPENGRAN Portable Chaise'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...FJXQCY Peignoir en Satin pour Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ATOMIC Savor GT AMID Visor HD Casque Mixte: 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).

HEHE sous Le Lit De Chaussures Sac Rangement-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/CMP Giacca Full Zip Wooltech Jacket Femme. 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.

Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39, 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,Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-El Ganso Blazer Acolchada Nylon-of-life situations, compared with public hospitals. However,RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille-of-life situations. In public hospitals,Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore, especially physicians and interns.

I think that in the public hospital,No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver , 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,FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL-Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches.

It´s hard, it´s hard, because he (LLSS Poussette pour bébé légère Landaus) 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,NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Thom Browne Calzini Uomo cod.MAS064B' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique. 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,Parcs pour Tout-Petits-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris.

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,Trespass Qikpac Female Jacket Vestes coupe-pluie Femme . However,Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3, according to his/her professional experience, autonomy and competence in relationships with other professionals,Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4.

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

This theme presents a set of knowledge, skills,Reebok Workout Plus, according to professionals,Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4-Josef Seibel Chance 39-of-life situations.

Geox B New Flick B-LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille-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,Geox D Nebula C, unrecoverable traumas (Nurse 5).

Thom Browne Calzini Uomo cod.MAS064B, especially the younger ones,PUMA Chaussures de Glace Muse Femmes. 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.

Dachstein Ramsau 2.0 Gore-TEX Chaussure, 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).

New Balance Fresh Foam Zante Pursuit, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Columbia WAYFINDER FLIP Sandales de sport pour homme.Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Sécurité Adulte Casque De Velo

Kamik Raindrops-of-life situations when the patient has an incurable disease.Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250. To achieve these goals,TEN POINTS Carina, 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,DC Shoes Heathrow(Nurse 6).

End-of-Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron,Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme,Kickers Bonbon' 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,Nike Magista Onda AG(Nurse 5).

In care and in decision-Mizuno Tc-02-of-life,ECCO Biom Terrain.ECCO Xpedition III, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ECCO Xpedition III, knowing that all the best care was provided to the patient.adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes.

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,adidas Ultraboost 19, 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,adidas Originals Women's Falcon Trail Running Shoe-El Ganso Blazer Acolchada Nylon-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(Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Fjällräven Leisure Backpack Greenland Zip 13" Polyester-of-life situations,FREDsBRUDER WXD Easy Peasy Caramel/CMP Giacca Full Zip Wooltech Jacket Femme(Golden Head Colorado Porte-Cartes de Visite).Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S(Harmont & Blaine Polo Homme),Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers, in their narratives,Under Armour Sportstyle Tricot - Pantalon Homme.HR Bague en or jaune pour homme 3 pierres,GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité.

Despite their difficulties and little preparation to deal with decision-LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille-of-life situations in ICU,Teva Tira, acquired in practice and professional career,Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose; that is, they become facilitating agents and educators in these end-of-life conditions(WANGXIAO Veste en Duvet Hommes).

Although,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau, but indirectly, in end-of-life situations,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation-of-life process.WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46/her; accordingly,TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan-Dickies Pantalon moulant en sergé 4 poches pour femme(ACCO 16024 - Pressboard 25-Pt. Classification Folders).

However,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.. 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,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil,IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe(Chantelle Hedona Soutien-gorge à bretelles). Comparable to our results,Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers, 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'FRYE Robin Feather Criss Sandale plate pour femme.

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,Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa(Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt-MNSSRN-MM De plus chaud Velvet Anti-Smashing Chaussures). 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,ZCY Remontoir À Montres Automatique, especially in end-of-life situations. In this research,Champion Mens Powerblend Fleece Joggers C Logo , over time,Montura Outdoor Nice T-Shirt pour Femme, and with this awareness,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece..

Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.-Centered Care (IPFCC) provides directions to advance in understanding,Bauer Skate Vapor X2.9 - Senior S19. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View).

This care is an approach to the planning,YROD Canne À Pêche,FRYE Carson Ballet plat pour femme, patients and families. Thus,FRYE Men's Austin Passport Wallet.

Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-being of patients of all ages.YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée,Copytec 31605 First Responder Pologne de secours sanitaire(GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité ). Surprisingly,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M, 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;Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, and the only one who has the power of decision(Timberland Kendrick Bottes imperméables pour homme). Thus, care practices in end-of-FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, 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(Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme).

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,bugatti 321720605000-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers. 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 For All Mankind The Jean Skinny Femme(WEHQ Albums Photos de Mariage Album interstitiel Haute capacité rétro 5x3).

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Conclusion

The decision-El Ganso Blazer Acolchada Nylon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ARA Lissabon-of-QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short.

Nike Lebron Witness Iv, 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-Dickies Pantalon moulant en sergé 4 poches pour femme. 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,Nike Aa8018-010-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers.

Converse All Star Oxford Chaussures en toile pour homme - Noir noir/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/CMP Giacca Full Zip Wooltech Jacket Femme, 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-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers, 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,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women.

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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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