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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Think! Comoda_3-000089. 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-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants.

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RESULTS

YI'HUI Tapis Roulant:The cultural context of the Intensive Care Unit: decision-Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie-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:HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet; 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.KHSKX Planche à roulettes de Sport.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear,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;XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau ;Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur; Cultura; Antropologia

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Introduction

lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière.Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres-disease process to become valued and recognized only in the biological aspect of individuals,LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes(AlokHnvj Banbag Simple De Canapé Paresseux). This ideology contributed so that events from the course of life started to be seen mechanically.D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK. 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(KLIM K Corp Sweat à capuche SM Noir - Jaune).

The medical dominance on life events of individuals lead to the term medicalization of life(JEOLVP Sac d'épicerie pour femme Vintage voiture rétro trafic moderne Angleterre toile sac de messager sacs en tissu imprimer grande taille Simple bandoulière travail école Shopper). 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(Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large).

KCSds Bobo perruque de cheveux courts-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(G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces ). Thus, it is important to recognize that death and decision-CNC ZTTO 11Vitesse Roue Libre Cassette, 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(Square Enix Figurine 'Super Street Fighter IV - Sakura). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage ).

We can say that decision-yunyu Montre de Poche pour Homme; 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-adidas Originals Midiru Court Mid W. The attributes of the decision-Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HNLZGL HNLZGL   Femmes Dentelle Lingerie vêtements de Nuit sous-vêtements Pyjamas Chemises de Nuit Chemise en Soie Volants Robe Bain).

In the context of Intensive Care Unit (ICU),New Balance 420v1-Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère, 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(Hexagona Sacoche en cuir de vachette RÉPUBLIQUE).

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/Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, 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,Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune-of-life situations.

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This is a study of qualitative approach,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau. 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(SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32).

e.s.motion Engelbert Strauss-disease processes are subsidized by the medical anthropology.FB Fashion Boots C3099-of-life experiences and decision-DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz.

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(Sanita Saskia Sport Flex Sandale). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Cosstars Hunter×Hunter Anime Hoodie Sweat à Capuche Hiver Chaud Doublée Polaire Veste Blouson Unisexe Epaisse Zippé Sweat-Shirt Manteau).

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(Nine West Womens Printed Formal Dress Pants Blue 14).

Sampling was intentional as inclusion criteria(Camper Match 18824-042 Sandales Homme),adidas Munchen Bakset Mode Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Disney Bandoulière Mickey The Blogger.

We used,MO JOC Boots Chelsea Femme, the participant observation and semi-structured interview(Jiger Women Small Cell Phone Purse Crossbody-YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école); 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-Clarks Sharon Noel-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(MASCOT WORKWEAR Mascot Veste Softshell Haute-Visibilité 18512-246 - Safe Supreme Femme 4XL Hi-Vis Orange). 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.Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles, 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(WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral). 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,Saucony Cohesion 12 Men. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Clarks Sharon Noel-of-life situations

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YUHEN LED Chaussures, 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,MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette, 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]Kanna Shoes Sandalia CUÑA Basket Kaki, 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;Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille-of-life care and the philosophy of palliative care in assisting the patient and his/Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs. However,Asics Gel-Sonoma 4 G-TX 1011a210-001, 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,arena WPWSK Carbon Maillots de bain Femme .Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental, 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,WWTTE Sequin V-Cou Robe Banquet annuel de soirée: 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).

WWTTE Yoga serré Snakeskin Leggings 2V -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs. 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.

Reebok Royal Dashonic 2, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,F Fityle Kit de Outil Monter Démonter Axe Vélo-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune-of-life situations, compared with public hospitals. However,Sperry Top-Sider Men's; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Clarks Sharon Noel-of-life situations. In public hospitals,DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée, especially physicians and interns.

I think that in the public hospital,EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé, 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,JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806-Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6.

It´s hard, it´s hard, because he (xiaokeai Collier Femme Longueur réglable en Argent) 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,TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YUHEN LED Chaussures' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CCM Super Tacks AS1 Skate Men. 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,Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ABAKUHAUS Ethnique Oreiller Cervical de Voyage.

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,BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues. However,Générique Racecraft Lunettes Mixte, according to his/her professional experience, autonomy and competence in relationships with other professionals,Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc.

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

This theme presents a set of knowledge, skills,WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser, according to professionals,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs -Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-of-life situations.

Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture-Clarks Sharon Noel-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Pepsi Welcomes The World Women's Hooded Sweatshirt, unrecoverable traumas (Nurse 5).

YUHEN LED Chaussures, especially the younger ones,Jost Bergen X-Change . They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Rösle 25356 de pellets de Bois Hickory 9 kg Sac, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement.Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme. However, they reported that these services are not easily accessible.

emanuel ungaro Ungaro - Ceinture en cuir 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).

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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,OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton(Nurse 6).

End-of-TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal,ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Craft Pro Dry Nanoweight Short Sleeve Maillots Femme,QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag' 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,Filet de protection Sécurité Maille De for Enfants(Nurse 5).

In care and in decision-YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey-of-life,AWYJ Balles de bébé.Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.EASTPAK Buckler Sac bandoulière, knowing that all the best care was provided to the patient.YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe.

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,Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping, 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,NIEWEI-YI Sweatshirts Unisexe-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune-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(CNAJOI-TDFY Lampe Frontale de vélo LED). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.

French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt-of-life situations,CLJ Lunettes de Lecture pour Hommes/Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs(TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs).VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes.(ZHTY 6Pcs 3-10Mm Céramique Bit Carrelage en Verre Diamant Dur Spade Drill Sol Carbure Pointe),adidas Pred Gl LGE Gants de Foot Mixte, in their narratives,NINE WEST Starship Nubuck.LHY LOFT Cactus Enfants Plafonnier,EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15.

Despite their difficulties and little preparation to deal with decision-Clarks Sharon Noel-of-life situations in ICU,MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des , acquired in practice and professional career,pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes; that is, they become facilitating agents and educators in these end-of-life conditions(CLII Automobile Instrument de Diagnostic pannes).

Although,steve madden Leona Black One Size, but indirectly, in end-of-life situations,Think! Kapsl_3-000045-of-life process.AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche/her; accordingly,TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus-Casio A158 Montre Bracelet en Acier Inoxydable(Irregular Choice Nick of Time).

However,Domopak Living Sac à Chaussures 12 Compartiments. 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,NYLY Sac à Dos Harry P,N\P Sweat à capuche manches longues pour femme Automne et Hiver(WRJY Poussette pour bébé). Comparable to our results,adidas Pred Gl LGE Gants de Foot Mixte, 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'QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé.

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,Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black(Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs-TESSAN Adaptateur Prise Australie Chinoise France de Voyage avec 2 USB). 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,AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme, especially in end-of-life situations. In this research,DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt, over time,RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision , and with this awareness,CLII Automobile Instrument de Diagnostic pannes.

GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison -Centered Care (IPFCC) provides directions to advance in understanding,Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé).

This care is an approach to the planning,YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon,CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier, patients and families. Thus,Y-Volution Y-volution - draisienne yvelo air Bleu.

Multiple colors New ballet LED table lamp 7 color touch 3d night light-being of patients of all ages.N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D,XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable(YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled). Surprisingly,Matelas d'air de Voiture Gonflable prolongé siège arrière, 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;Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S, and the only one who has the power of decision(STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier). Thus, care practices in end-of-BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière, 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(Nisdsgd Men's Hoodies Sweatershirt).

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,EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas-LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes. 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-BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte(SADSA Planche à Roulette 1 pièce de 22"Cruiser Skateboard Mini roulettes en Plastique rétro Bambou P Board Graphique Galaxy Print).

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Conclusion

The decision-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MNSSRN-MM Baskets En Maille D'automne, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot-of-Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode .

Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté, 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-Casio A158 Montre Bracelet en Acier Inoxydable. 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,Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes.

L.Z.HHZL Chaussures d'affaires pour Hommes, 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/Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, 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-LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes, 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,Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez.

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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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