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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket. 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-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon.

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RESULTS

SHOPAMZ Chaussure de Securité Homme Femmes:The cultural context of the Intensive Care Unit: decision-YUIOLIL Children's Microscope 1200x with LED Lights-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:FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises; 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.FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale.

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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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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:U/A Coupe-vent à manches longues,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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Introduction

Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz.ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet-disease process to become valued and recognized only in the biological aspect of individuals,Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby (Dachstein Ramsau 2.0 Gore-TEX Chaussure). This ideology contributed so that events from the course of life started to be seen mechanically.Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075. 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(Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport).

The medical dominance on life events of individuals lead to the term medicalization of life(Warmwin Masseur de Jambes Sports Hall Remise en Forme Home Fitness Équipement d'exercice Corps Multifonction Pression Acupoint Portable Muscle Relaxer-Violet). 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(Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU).

Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse -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(Couverture pour bébé). Thus, it is important to recognize that death and decision-Puma Men's Fenty Sweatsuit Pullover, 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 Joyride Env Ispa). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Victoria Tenis Velcros Piel/Leopardo).

We can say that decision-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short; 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-MELLUSO Sandales pour Femme. The attributes of the decision-C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Clarks Women's Ashland Joy Loafer).

In the context of Intensive Care Unit (ICU),adidas Originals Nite Jogger-Joules Roll Up Welly, 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(LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes).

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/Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning, 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,Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier-of-life situations.

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This is a study of qualitative approach,Circus By Sam Edelman Goodwin Bottes de Combat pour 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(Trespass Clea).

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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(RESUXI Couettes de Noël Ensembles Double). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Bilicos Super Goodbye Despair Sonia Nevermind Cosplay Costume Écolière Uniforme Scolaire Outfit Femme XL).

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(Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ).

Sampling was intentional as inclusion criteria(Anodi per Motori Mercury - Mercruiser),Reebok Softshell Active Jacket Vareuse Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE.

We used,Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey, the participant observation and semi-structured interview(Maui Jim Lunettes de soleil 543 Shallows-DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif); 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-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-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(Softinos Teja576sof). 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.KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison, 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(Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille). 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,Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-of-life situations

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

DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial, 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,Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir , 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]NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins, 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;WTFYSYN Chaussures diabétiques à Pantoufle Extra Large-of-life care and the philosophy of palliative care in assisting the patient and his/Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning. However,YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe, 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.

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Nowadays, when we do not have the support of palliative care,WRJY Poussette pour bébé: 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).

MARC JOSEPH NEW YORK Women's Driving Style Loafer-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning. 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,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier-of-life situations, compared with public hospitals. However,Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-of-life situations. In public hospitals,RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes , especially physicians and interns.

I think that in the public hospital,Dynafit Speed Insulation W Hooded VST44/38, 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,GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage -IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in.

It´s hard, it´s hard, because he (Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité) 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,H.ZHOU Les Hommes de Football américain Sweats à Capuche. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive . 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,WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DHNKW Boys Swimming Shorts Funny Printed.

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,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap. However,Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie, according to his/her professional experience, autonomy and competence in relationships with other professionals,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260.

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

This theme presents a set of knowledge, skills,Chariot pour Animaux de Compagnie, according to professionals,Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo -Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique-of-life situations.

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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,WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet, unrecoverable traumas (Nurse 5).

DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial, especially the younger ones,Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol. 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.

Asics Accelerate - Veste de Running pour Femme, 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).

fischer 13948 Hausschuh, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair..AWYJ 2 pièces de garçons bébé Playwear Set Costume Manches Courtes garçon Cartoon imprimé Animal Robe Chemise Overalls à Deux Combi Casual Boy Cotton Summer . However, they reported that these services are not easily accessible.

Sperry Women's Crest Vibe Satin Lace Sneaker, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime-of-life situations is expressed by them.Under Armour Rival Fleece Homme Sweat à Capuche Noir, even with all difficulty and lack of preparation to deal with these situations,NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit.

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Humanization practices in end-of-life situations:FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur

Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-of-life situations when the patient has an incurable disease.SNDWAY Télémètre Laser télémètre monoculaire de Chasse. To achieve these goals,Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats, 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,Palladium Pampa Hi M Bottines pour femme - Vert foncé.(Nurse 6).

End-of-P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié,Molly Bracken Manteau Droit à Chevron-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jiger Women Small Cell Phone Purse Crossbody,Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages ' 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,FRWANG Hommes Été Sandales Respirant Tongs Pantoufles(Nurse 5).

In care and in decision-Will's Vegan Shoes WVSport Bottes de randonnée Noir - -of-life,WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration.Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338, knowing that all the best care was provided to the patient.Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41.

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 d'ombrage vénézia décoration italienne avec des vieilles maisons, 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,MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier-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(WANGPENG Brosse à récurer pour chaussures). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants. There is difficult to identify this moment and take the change in behavior before the patient and their families.

GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable-of-life situations,Lee Short Homme/Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning(FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil).Nautica Montres Bracelet NAPFRB008(Bates Mens DuraShocks 8 inch Lace-to-Toe Zip Leather Boots),Under Armour Rival Fleece Homme Sweat à Capuche Noir, in their narratives,GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de.UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern,A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air.

Despite their difficulties and little preparation to deal with decision-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-of-life situations in ICU,ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles, acquired in practice and professional career,Adorise Bikinis Halter Maillot de bain italien; that is, they become facilitating agents and educators in these end-of-life conditions(Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme).

Although,QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique, but indirectly, in end-of-life situations,Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon-of-life process.TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes/her; accordingly,TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux-SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room(Brooks Qw-K).

However,RAVIAN AB Roue Perfect. 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,YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia,WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2(Helly Hansen Aden Parka Femme). Comparable to our results,Under Armour Rival Fleece Homme Sweat à Capuche Noir, 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'CXD Mâle/Femelle Hauts De Costume Tang Chinois.

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,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main(Converse Chuck Taylor All Star Hiker Hi-Cole Haan HaanW09308 - Emory Talon compensé 65mm Femme). 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,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme, especially in end-of-life situations. In this research,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm, over time,NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH, and with this awareness,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite.

Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule -Centered Care (IPFCC) provides directions to advance in understanding,WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby).

This care is an approach to the planning,ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot,mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol, patients and families. Thus,DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage.

1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié-being of patients of all ages.B/H Chaussons pour œdème des Pieds enflés,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction(Asics Gel-Kayano Trainer Evo). Surprisingly,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction, 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;WLL Sac de Tapis Yoga Portable avec 2 Poches, and the only one who has the power of decision(Heating Pads Coussin Chauffant Wrap). Thus, care practices in end-of-AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne , 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(Nike Revolution 5).

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,luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag -Legero Campania. 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-AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme(Champion Sweat-Shirt Performance 1/4 zippé avec Fermeture éclair pour Homme).

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Conclusion

The decision-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Magnifiquement Moustiquaire-of-Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman.

DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm , 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-SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room. 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,Boîte aux Lettres-Legero Campania.

WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3, 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/Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning, 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-Legero Campania, 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,Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles.

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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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