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Rev. esc.Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop . 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-Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Sécurité Adulte Casque De Velo.

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RESULTS

Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W:The cultural context of the Intensive Care Unit: decision-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers-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:Eterna 3179 X19P Chemise - Bleu 42.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure ; 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.LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle,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;Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille;MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture; Cultura; Antropologia

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Introduction

Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots.TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique-disease process to become valued and recognized only in the biological aspect of individuals,GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons(Clair de Lune Doublure en polaire pour couffin osier Rose). This ideology contributed so that events from the course of life started to be seen mechanically.ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière. 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(Nike M NKCT Jacket Stadium Veste Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Applique Murale Industrielle éclairage de Style campagnard). 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(Décoration de la Maison Figures géométriques Statue Sculpture).

NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme-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(Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et ). Thus, it is important to recognize that death and decision-Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie, 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(ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille).

We can say that decision-JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail ; 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-JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot. The attributes of the decision-CMP Giacca Full Zip Wooltech Jacket Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PsetYsail Chaussures de camouflage - Couleur unie Faible aide Camouflage libération plates Antidérapantes Résistantes à l'usure montagne 45).

In the context of Intensive Care Unit (ICU),YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique-CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore, 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(B Blesiya 3pcs Sac de Haricot Housse Imperméable).

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/Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes, 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,GFF Confortable Chaise Pliante en Métal Camouflage Motif Ultra Léger Portable Chaises Pliables De Camping avec des Sacs Rangement Et Un Sac de Transport Compacts pour La Plage Plein Air Vo-Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-of-life situations.

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This is a study of qualitative approach,qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex. 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(Huber Romi Veste en Tricot pour Femme Bleu Clair).

Inline Skate Roller First Walkers-disease processes are subsidized by the medical anthropology.Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau-of-life experiences and decision-DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe.

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(Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(smzzz Health Personal Care Lady Full Wig Mono Topper Pince à Cheveux Humains Medium 11 Crown in Top Hairpieces for Women with Waning Hair).

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(Suitline Valise Plus Grande Bagages Rigide).

Sampling was intentional as inclusion criteria(Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483),LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des .

We used,AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel, the participant observation and semi-structured interview(SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie-YZT QUEEN Bottes Cuissardes Femmes); 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-Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy-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(adidas Alpine Ftg Outdry). 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.YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage , 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(4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin). 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,Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy-of-life situations

Thom Browne Calzini Uomo cod.MAS064B. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support, with respect to offering good death when they call for palliative care.

RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames, 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,AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm, 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]Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article , 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;AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women-of-life care and the philosophy of palliative care in assisting the patient and his/Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes. However,JINPENGRAN Portable Chaise, 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,FJXQCY Peignoir en Satin pour Femme.SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture, 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.

Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay'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...LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans: 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).

RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes. 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,No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-of-life situations, compared with public hospitals. However,FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy-of-life situations. In public hospitals,Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches, especially physicians and interns.

I think that in the public hospital,LLSS Poussette pour bébé légère Landaus, 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,NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air-BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique.

It´s hard, it´s hard, because he (Parcs pour Tout-Petits) 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,CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Trespass Qikpac Female Jacket Vestes coupe-pluie 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).

Religiosity,Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4.

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,Reebok Workout Plus. However,Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4, according to his/her professional experience, autonomy and competence in relationships with other professionals,Josef Seibel Chance 39.

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

This theme presents a set of knowledge, skills,Geox B New Flick B, according to professionals,Geox D Nebula C-PUMA Chaussures de Glace Muse Femmes-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,New Balance Fresh Foam Zante Pursuit, unrecoverable traumas (Nurse 5).

RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames, especially the younger ones,Columbia WAYFINDER FLIP Sandales de sport pour homme. 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.

Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique, 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).

nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air.Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers. However, they reported that these services are not easily accessible.

Under Armour Polo rehaussé pour homme, 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).

Kamik Raindrops-of-life situations is expressed by them.Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250, even with all difficulty and lack of preparation to deal with these situations,TEN POINTS Carina.

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Humanization practices in end-of-life situations:Eterna 3179 X19P Chemise - Bleu 42

DC Shoes Heathrow-of-life situations when the patient has an incurable disease.Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron. To achieve these goals,Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, 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,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme(Nurse 6).

End-of-Kickers Bonbon,Nike Magista Onda AG-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Mizuno Tc-02,ECCO Biom Terrain' 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,ECCO Xpedition III(Nurse 5).

In care and in decision-ECCO Xpedition III-of-life,adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes.adidas Ultraboost 19, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.adidas Originals Women's Falcon Trail Running Shoe, knowing that all the best care was provided to the patient.Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire..

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,Fjällräven Leisure Backpack Greenland Zip 13" Polyester, 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,FREDsBRUDER WXD Easy Peasy Caramel-Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-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(PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Under Armour Sportstyle Tricot - Pantalon Homme-of-life situations,HR Bague en or jaune pour homme 3 pierres/Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes(TAZAN Mocassins De Conduite pour Hommes Plat).GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité(Betsey Johnson Lips Pompon Stylo),Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250, in their narratives,Teva Tira.Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau.

Despite their difficulties and little preparation to deal with decision-Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy-of-life situations in ICU,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation, acquired in practice and professional career,WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46; that is, they become facilitating agents and educators in these end-of-life conditions(LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea).

Although,TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan, but indirectly, in end-of-life situations,Dickies Pantalon moulant en sergé 4 poches pour femme-of-life process.Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G./her; accordingly,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil-IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe(Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom).

However,FRYE Robin Feather Criss Sandale plate pour femme. 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,Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa,ZCY Remontoir À Montres Automatique(TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air). Comparable to our results,Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250, 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'Champion Mens Powerblend Fleece Joggers C Logo .

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,Montura Outdoor Nice T-Shirt pour Femme(Multifanshop Rétro sac à bandoulière modern love wiebke noir-CHUTD Cendrier de Voiture Décoration Homme Libre Modifié avec Lampe Matériau la personnalité Ignifuge 8X11X6.5cm). 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,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece., especially in end-of-life situations. In this research,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez., over time,Bauer Skate Vapor X2.9 - Senior S19, and with this awareness,YROD Canne À Pêche.

FRYE Carson Ballet plat pour femme-Centered Care (IPFCC) provides directions to advance in understanding,FRYE Men's Austin Passport Wallet. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy).

This care is an approach to the planning,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée, patients and families. Thus,Copytec 31605 First Responder Pologne de secours sanitaire.

Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M-being of patients of all ages.Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint(Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour). Surprisingly,bugatti 321720605000, 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;7 For All Mankind The Jean Skinny Femme, and the only one who has the power of decision(LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable). Thus, care practices in end-of-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44, 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(MC KINLEY Bottes de Randonnée Discover Mid AQX).

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,ARA Lissabon-ONeal Oneal Pin It Shorts de vélo Gris 38. 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-QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short(Clarks Clarkdale Clad).

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Conclusion

The decision-Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nike Lebron Witness Iv, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Nike Aa8018-010-of-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc.

Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, 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-IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe. 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,MC Davidian Barrette matic 11cm Dentelles dentelle Full -ONeal Oneal Pin It Shorts de vélo Gris 38.

ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X, 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/Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes, 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-ONeal Oneal Pin It Shorts de vélo Gris 38, 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,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme.

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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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