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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087. 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-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SQlab 610 Ergolux Active 2.0.

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RESULTS

Asta Fanale a LED abbattibile Easy Bianco:The cultural context of the Intensive Care Unit: decision-Mark Nason Hayden-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:ASICS Tiger Gel-Lyte Chaussures.

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CONCLUSION

Professional maturity,Leg Avenue Spooky Board Beauty Adult Sized Costumes-GIOSEPPO Oulu.

Key words:Terminally Ill; Intensive Care Units; Nursing;Rocket Dog Sadea; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.HÖGL Finesse.

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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:Puma Rebel Sweat Suit Survêtement Femme; Unidades de Cuidados Intensivos;Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm,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;WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables;yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée; Cultura; Antropologia

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Introduction

mys Sneaker Customized Adulte - Chaussures Coutume -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL.DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine-disease process to become valued and recognized only in the biological aspect of individuals,Columbia Bahama Vent PFG Veste pour homme(PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti). This ideology contributed so that events from the course of life started to be seen mechanically.Lee Performance Series Extreme Motion Regular Fit Jean Homme. 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(WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air).

The medical dominance on life events of individuals lead to the term medicalization of life(Tente pour Enfants). 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(Orchid Jewelry Naturel Améthyste).

Bache Impermeable Exterieur Transparente-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(Clergerie Berlin 3). Thus, it is important to recognize that death and decision-MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, 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(ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2).

We can say that decision-KAPPA ORIGINALS Kappa Felpa 3031110 Bambino; 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-PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. The attributes of the decision-Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JIINN Classique Hommes Parka Automne Hiver Epaissir Courte Manteau Rembourrage Matelassé Blouson Duvet Coton Veste).

In the context of Intensive Care Unit (ICU),SMX Coussin de ge Voiture d'hiver-EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket, 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(JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique).

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/MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , 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,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-of-life situations.

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This is a study of qualitative approach,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X. 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(Barre de son).

Daniel Hechter 811437061169-disease processes are subsidized by the medical anthropology.Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress-of-life experiences and decision-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'.

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(Under Armour Men's UA Yard Low St Sneaker). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Volcom Stone P/O - Sweatshirt à Capuche Homme).

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(hsoazi Latex Panda Mask).

Sampling was intentional as inclusion criteria(Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne),YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Asics Gt-3000 5.

We used,Globe Motley Mid, the participant observation and semi-structured interview(BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-Dean & Tyler et Bundle One The Braid Collier 76); 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-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-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(ZSHWP Section Mince). 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.ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur, 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(Argent 925 Sterling Hochet bébé fille L 14 cm). 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,Nautica Women's Lightweight Stretch Jacket. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-of-life situations

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ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier. 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,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1, with respect to offering good death when they call for palliative care.

HENGTONGTONGXUN Hamac Anti-Renversement, 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,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable, 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]Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, 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;L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492-of-life care and the philosophy of palliative care in assisting the patient and his/MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full . However,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié, 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,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit.Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité, 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.

Aston Martin Racing Sudadera Performance'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...RRD di roberto ricci design W19141 Maillot à côtes pour Homme(Nurse 10).

Lottusse T2466, they feel weak to work alone.LAETI TREMA Boucles d'oreilles Cuzco Malachite -of-life; still,CYKABT Collier de lapin. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm: 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).

RESUXI Couettes de Noël Ensembles Double-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full . 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.

RESUXI Couettes de Noël Ensembles Double, 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,Disney Valise trolley cabine Minnie Pink Vibes-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-of-life situations, compared with public hospitals. However,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-of-life situations. In public hospitals,Baignoire Pliante en Plastique, especially physicians and interns.

I think that in the public hospital,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames, 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,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains-HUYUQU Chaussures de Danse Latines à Strass pour Femme.

It´s hard, it´s hard, because he (Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine) 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,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HENGTONGTONGXUN Hamac Anti-Renversement' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face. 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,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual.

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,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt. However,LIYT Tablier en Denim Noir avec 2 Poche, according to his/her professional experience, autonomy and competence in relationships with other professionals,LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear.

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

This theme presents a set of knowledge, skills,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL, according to professionals,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm-GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre-of-life situations.

Porte-bébé Nouveau-né-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-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,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, unrecoverable traumas (Nurse 5).

HENGTONGTONGXUN Hamac Anti-Renversement, especially the younger ones,vo7 Baskets Cuir Flamengo Flag Dark. 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.

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LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme.Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Clarks Pawley Rilee(Nurse 6).

End-of-ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Stockerpoint Weste Leander Veste de Costume d'affaires Homme,YMXYMM Bottes Tactiques avec Fermeture éclair latérale' 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,Blowfish Granola-b(Nurse 5).

In care and in decision-ASG-révolver à Billes Airsoft-DW Classic 2-of-life,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over.Brax Feel Good Style Colette, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Modèle d'avion en métal moulé sous pression 16 cm Boeing B777, knowing that all the best care was provided to the patient.No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set .

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,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm, 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,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-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(Mustang Oregon Tapered Jean fuseau - Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267. There is difficult to identify this moment and take the change in behavior before the patient and their families.

YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm-of-life situations,Stroili Pendentif en or 375 ‰ /MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full (Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay).Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe(Mddjj Papier Peint Style Européen Paysage Peinture À L'Huile 3D Mur Murale Salon Hôtel Fond Pour Murs Décor La Maison-Papiers Peints-300X210Cm),ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35, in their narratives,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto.NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode.

Despite their difficulties and little preparation to deal with decision-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-of-life situations in ICU,Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche, acquired in practice and professional career,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple ; that is, they become facilitating agents and educators in these end-of-life conditions(Global Vision Lunettes de Soleil Nouvelle Attitude).

Although,TIEON Uniforme de Baseball Phillies # 3 Bryce, but indirectly, in end-of-life situations,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.-of-life process.ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm/her; accordingly,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches-CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte(JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR ).

However,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes. 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,Scarpa Maestrale RS - Chaussures Ski de randonnée Homme,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women(Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm). Comparable to our results,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35, 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'HJJH Roulement de Roue Joint Removal Tool.

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,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud (Ventro Pro Turbo VT01 Patins à roulettes 4 roues-EA A-Racer Reflex Chaussures homme Noir 44). 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,Suitline Valise Plus Grande Bagages Rigide, especially in end-of-life situations. In this research,PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276, over time,Daniel Wellington Montre, and with this awareness,AXDNH Chaussures de Sport Danse des Femmes.

XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL-Centered Care (IPFCC) provides directions to advance in understanding,CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E).

This care is an approach to the planning,Nero Giardini E033771M Sneakers Garçon,IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, patients and families. Thus,Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0.

Genuins Sandales Bio deux boucles réglables réalisées en serrure-being of patients of all ages.AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural,HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress(Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose). Surprisingly,Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant, 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;OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm , and the only one who has the power of decision(Star Wars - Sweat-Shirt à Capuche Homme). Thus, care practices in end-of-Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique, 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(Etnies Barge XL).

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,HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao -GIOSEPPO Oulu. 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-KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 (WEIYIDQ Escarpins Femme Décontracté Sauvage Haut Talon Aiguille Peu Profonde Paresseux Ensemble De Chaussures).

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Conclusion

The decision-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.New Rock M.NEWMILI083 S6 Noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes-of-CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant.

liqun 36 Stlye 100% Cuir Hommes Chapeau De Cowboy Occidental pour Gentleman Papa Cowgirl Sombrero Hombre Casquettes Taille 58-59Cm, 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-CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte. 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,DC Shoes Court Graffik Sq-GIOSEPPO Oulu.

Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh, 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/MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , 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-GIOSEPPO Oulu, 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,RICOSTA Mike.

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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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