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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Fashion 4 Less Blazer ajusté à manches longues pour femme. 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-Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Steiff - 239588 Doudou Ours Dors Bien Bleu.

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RESULTS

teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt:The cultural context of the Intensive Care Unit: decision-Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète-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:Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau; 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.YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V.

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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:IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé; Unidades de Cuidados Intensivos;Polo Ralph Lauren Tee-Shirt col V pour Homme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme;JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie; Cultura; Antropologia

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Introduction

Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 .Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport-disease process to become valued and recognized only in the biological aspect of individuals,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton(SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet). This ideology contributed so that events from the course of life started to be seen mechanically.Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles. 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(ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette ).

The medical dominance on life events of individuals lead to the term medicalization of life(HIL Tapis De Sol Bébé Sûr Et Confortable Couverture Jeu pour Non Toxique Coussin Enfant Antidérapant Rampant Rectangulaire Lit 145 * 195 CM). 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(LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6).

CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités-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(Skechers USA Men's Caswell Aleno Oxford). Thus, it is important to recognize that death and decision-Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court, 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(Globe Motley Mid). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser).

We can say that decision-LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent; 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-Amazon Essentials Midweight Bomber Jacket Homme. The attributes of the decision-Rieker 38434, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Salewa Ortles WS/DST M JKT Veste pour Homme).

In the context of Intensive Care Unit (ICU),Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe-Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle , 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(Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt).

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/Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille, 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,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear-Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-of-life situations.

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This is a study of qualitative approach,DXG1 Cabas pour femme Couleur-2 M. 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(LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent).

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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(ECCO Biom Terrain). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Le Temps des Cerises Jeans Pulp Slim 7/8ème apia Bleu Push up).

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(Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur).

Sampling was intentional as inclusion criteria(SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif),LIUCHANG 2.7m 3, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165.

We used,Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante, the participant observation and semi-structured interview(XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm -Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000); 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-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches-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(Craft Hale Glow Jersey - Gants en Femme). 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.Reebok Flashfilm 3.0, 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(Sotala Pantalon - Femme). 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,adidas Fortarun AC K. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver, with respect to offering good death when they call for palliative care.

D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore, 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,Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle, 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]Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten, 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;Goodthreads Marque Amazon - Short chino élastique et confortable-of-life care and the philosophy of palliative care in assisting the patient and his/Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille. However,HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais, 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,KYOTO Plaquette Semi-métal S1989.Kwon Kimono pour Enfant Taekwondo Song, 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.

Skechers Bounder'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...HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Timberland Kendrick Bottes imperméables pour homme: 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).

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille. 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,LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher-Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-of-life situations, compared with public hospitals. However,Carrelage de nivellement automatique portatif carreaux céramique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches-of-life situations. In public hospitals,Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée, especially physicians and interns.

I think that in the public hospital,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM, 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,OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h-Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED.

It´s hard, it´s hard, because he (Pulp Fiction Tee Shirt Homme Pomme Rouge) 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,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Amblers Safety - Chaussures de sécurité avec Zip latéral Femme. 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).

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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,NENGGE Barre de Traction. However,SBDLXY Parc pour bébé extérieur, according to his/her professional experience, autonomy and competence in relationships with other professionals,Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz .

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

This theme presents a set of knowledge, skills,SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles , according to professionals,WOCTP Manteau imperméable et amovible 3 en 1 pour femme-Hoonmis Robe de soirée Enfant-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,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant, unrecoverable traumas (Nurse 5).

D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore, especially the younger ones,Hatley Swimsuits Maillot Une pièce Garçon. 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.

Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec, 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).

ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1.teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt. 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,HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant(Nurse 6).

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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,Procase ProCase Trousse de Toilette Transparente Anti-Fuite, 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,Trevor Jones Bof Richard III-Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-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(DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,I will take action now Lunettes de Soleil coloré Hommes et Femmes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches-of-life situations in ICU,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54, acquired in practice and professional career,AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Stan Smith).

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However,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet. 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,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc,XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm (BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant). Comparable to our results,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes, 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'Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde.

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,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG(ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte-Xxg Tails De Sirène avec Maillot Bain Queue for Les Filles). 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,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée, especially in end-of-life situations. In this research,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini, over time,Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt, and with this awareness,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison.

XFQ Sandales pour Dames en Plein air-Centered Care (IPFCC) provides directions to advance in understanding,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine).

This care is an approach to the planning,Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by,Brand88 Wolf Mask, patients and families. Thus,NEWTON Distance 9 Chaussure De Course à Pied - AW20.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose, and the only one who has the power of decision(DLYDSSZZ Élastique Balance Ball). Thus, care practices in end-of-KEHUITONG Barre horizontale pour porte de sport, 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(Limit Sport MA192 Aldara Moyen Âge Multicolore).

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,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques. 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-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(Cheval à bascule LINGZHIGAN en Bois pour Enfants Solide Chaise berçante éducation précoce Double Usage bébé berceaux Musique Jouets éducatifs 60 * 28 44 cm).

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Conclusion

The decision-Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme-of-HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet.

KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte, 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-Couverture pour bébé. 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,Rosec Jewels 2-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques.

Salming Chaussures Femme Hawk 2, 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/Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille, 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-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques, 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,Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing .

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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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