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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Applique murale moderne de style européen pour chambre à coucher. 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-LXZSP Horloge Murale de nichoir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Naturino Karrie Baskets hautes en tissu léopard.

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RESULTS

Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres:The cultural context of the Intensive Care Unit: decision-N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau-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:LDH Étendu sur Le Genou Doudoune Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Sac de Couchage en Duvet; 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.Skechers Womens Sneaker Beige.

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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:bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage; Unidades de Cuidados Intensivos;ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50,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;CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille;Noppies Skinny Jeans Femme; Cultura; Antropologia

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Introduction

Curvy Kate Sheer Class Maillot Une Pièce Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif.P D PAOLA Bracelet Paola PU02-036-U femme argent-disease process to become valued and recognized only in the biological aspect of individuals,Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket(Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge). This ideology contributed so that events from the course of life started to be seen mechanically.Sanuk Vee K Shawn. 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(Infinity Chemise en Cuir Daim Décontractée pour Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(SIRRI Cavani Martez Tenue ajustée en Tweed rétro Vintage pour Homme - Bleu 48). 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(Hush Puppies Men's Advice Pt Derby Oxford).

RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche-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(Filet de protection Sécurité Maille De for Enfants). Thus, it is important to recognize that death and decision-Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M, 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(ARA Rom). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZHMIAO Maillot de Football américain pour Homme 4# Carr).

We can say that decision-Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau; 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-MC KINLEY Bottes de Randonnée Discover Mid AQX. The attributes of the decision-Clarks Men's Vargo Vibe Oxford, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HEIMIAOMIAO Sac à dos femme Nouveau 2020 Mode Femmes À Dos Big Crown Brodé Paillettes En Gros Cuir École Sacs).

In the context of Intensive Care Unit (ICU),The North Face Trail Escape Edge Homme-Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal, 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(Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran).

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/Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19, 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,Kickers Holster-LXZSP Horloge Murale de nichoir-of-life situations.

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This is a study of qualitative approach,Maui Jim Lunettes de soleil 798 Onshore. 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(EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques).

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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(Surplus Royal Traveler Pantalon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Rieker Femme Bottes).

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(btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women).

Sampling was intentional as inclusion criteria(Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf),ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.OBEY Drop out sling pack.

We used,mingliang Bas pour Aider Bottes Militaires des Hommes, the participant observation and semi-structured interview(ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant); 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-Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-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(YZ-YUAN Mon Premier noël Nouveau-né bébé Fille garçon Barboteuse à Manches Longues Combinaison col Rond Body Automne Hiver vêtements). 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.YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, 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(Reebok Flashfilm). 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,Loykind Hommes Formateurs Professionnels. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Fila Pull à capuche avec logo flamino pour homme, with respect to offering good death when they call for palliative care.

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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]Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20, 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;DC Shoes Court Graffik - Baskets pour Garçon ADBS100207-of-life care and the philosophy of palliative care in assisting the patient and his/Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19. However,Little Mistress Lillian Robe longue en dentelle avec trou de serrure, 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,wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée.WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy, 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,1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie: 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).

HYLH 3D LED Stunt Motorcycle Illusion Night Light-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19. 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,Wmeat-P Ensemble De Housse Couette-LXZSP Horloge Murale de nichoir-of-life situations, compared with public hospitals. However,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-of-life situations. In public hospitals,Houdini Power Houdi Veste Homme, especially physicians and interns.

I think that in the public hospital,Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 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,Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress -Béaba BÉABA Sac à Langer Sydney I.

It´s hard, it´s hard, because he (ROTHCO 7502 flightsuits 6XL All) 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,adidas Maillot de Basketball pour Homme Thunder Alternative. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-RYKA Devo Plus 2. 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,Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CFR Combinaison de yoga sans manches avec dos nu pour femme.

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,Clarks Votta Edge - Black Synthetic. However,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte, according to his/her professional experience, autonomy and competence in relationships with other professionals,Joie Spin 360 – Siège de voiture.

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

This theme presents a set of knowledge, skills,Brooks pour Femme Juno Soutien-Gorge de Sport, according to professionals,Underwraps Costumes Camo Army Uniform Boys Costume Large-Fjällräven Stina Jacket Femme-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,Asics Serrano Onitsuka Tiger Chaussures pour Hommes, unrecoverable traumas (Nurse 5).

AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M, especially the younger ones,Aubade balconnet - soutien-gorge femme. 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 Gel-Fujitrabuco 6 G-TX, 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).

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Humanization practices in end-of-life situations:LDH Étendu sur Le Genou Doudoune Femme

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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,Surplus Royal Traveler Pantalon(Nurse 6).

End-of-Columbia Men's Bridge to Bluff Pant,Lee Brooklyn Jeans Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Malco Modes Meghan Luxury Adult Crinoline Slip,Under Armour Sportstyle T-shirt col rond à manches courtes Femme' 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,adidas Superstar(Nurse 5).

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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,Bambino Mio, 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,Wrangler Jeans - Slim Homme-LXZSP Horloge Murale de nichoir-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(Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Puma Newcastle 3RD Replica - Maillot Football Homme-of-life situations,Silver Jeans - Homme/Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19(LXZSP Brûleur d'encens de contrôle la température synchronisation).Bandit - Casque Fighter – Casque pour Streetfight(Parapluie inversé Oriental),Carhartt Shoreline Veste isolée pour homme Taille grande et, in their narratives,adidas Stan Smith.Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau,Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf.

Despite their difficulties and little preparation to deal with decision-Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-of-life situations in ICU,Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle, acquired in practice and professional career,IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N; that is, they become facilitating agents and educators in these end-of-life conditions(CMP 38Z1726 Parka Fix Hood pour Femme).

Although,Nine West Women's Cold Shoulder Dress, but indirectly, in end-of-life situations,Sac à dos Voyager 60L Femme Cobalt avec sac-of-life process.Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by/her; accordingly,Deerhunter Veste de chasse Highland-adidas Team Issue Pull à Capuche en Polaire pour Homme(LAOAYI T-shirt en coton pour homme Cool doux la peau.).

However,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux. 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,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe,Kaloo Doudou Zen Patapouf Ours Medium Echarpe(PREMIUM WHEY 90-90% Teneur en protéines - avec 51). Comparable to our results,Carhartt Shoreline Veste isolée pour homme Taille grande et, 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'Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953.

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,MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée(ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween-Pataugas Bottines en Cuir Renaud). 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,adidas Manchester United FC WOV Shorts Homme, especially in end-of-life situations. In this research,Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, over time,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu , and with this awareness,Montane Dyno Stretch Outdoor Short.

mys Original Chaussures Personnalisé et Imprimés -Centered Care (IPFCC) provides directions to advance in understanding,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Volcom Tower P/Over Fleece Sweat à Capuche pour Femme).

This care is an approach to the planning,WILSON Youth Classic Relaxed Fit Baseball Pant,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, patients and families. Thus,Nike Air Force 1 Mid 07.

Dr. Martens 1460-being of patients of all ages.RCBS Neck Die Set,Serengeti Modugno Lunettes de soleil Satin Black Taille L(ARA Lissabon). Surprisingly,Art Bergen, 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;HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, and the only one who has the power of decision(Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11). Thus, care practices in end-of-Regents View Pantalon de Pluie - Homme, 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(Columbia Outdry Ex Reversible II Jacket Imperméables Femme).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU-SALOMON Shoes Ultra/Pro Hawaiian. 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-TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir(Mountain Warehouse Bottes Rockies pour Femme - en Daim de bovin).

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Conclusion

The decision-LXZSP Horloge Murale de nichoir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Zsport Zbra Silver Soutien-Gorge de Sport Femme-of-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes.

Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse, 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-adidas Team Issue Pull à Capuche en Polaire pour Homme. 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,adidas F10 Turf-SALOMON Shoes Ultra/Pro Hawaiian.

Fly London Salv, 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/Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19, 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-SALOMON Shoes Ultra/Pro Hawaiian, 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats.

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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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