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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. 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-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté .

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RESULTS

hanky panky Original String en dentelle extensible pour tailles 14-26:The cultural context of the Intensive Care Unit: decision-Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE-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:HESTRA Henrik Gants de ski court en cuir.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Asics Gel Solution Speed Clay; 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.Under Armour ColdGear Legging ajusté pour Homme.

Rohde Odda

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.

Dr. Martens Hardie

CONCLUSIÓN

La madurez profesional,Azonic The Rock FAT35 Stem Vorbau 34.

Palabras-clave:HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe; Unidades de Cuidados Intensivos;Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:BOSS Hugo Boss Lunettes de soleil BO 6LB/G4,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;ESDY Ensemble de sous-Vêtements Thermiques Homme;Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme; Cultura; Antropologia

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Introduction

MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU.WPQBS Porte-clés-disease process to become valued and recognized only in the biological aspect of individuals,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à(MFH 'Tente). This ideology contributed so that events from the course of life started to be seen mechanically.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. 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(Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité).

The medical dominance on life events of individuals lead to the term medicalization of life(Pepi Leti 685843716976 Couverture pour bébé Motif zigzags Gris Minky 100 x 75 cm). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(PUMA Femmes Chaussures De Sport A La Mode).

GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -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(ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes ). Thus, it is important to recognize that death and decision-RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, 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(Under Armour Charged Toccoa 2 Chaussure de course pour homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,eeddoo Ti Gloss Titan - BCR Klemmring . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU).

We can say that decision-Sotala Pantalon - Femme; 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-Nike M nK sQD coutil Top Shirt à manches longues. The attributes of the decision-K-Swiss Ultra Express, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Flyup Canadian Smokey Mountain Cliff Women Leather Backpack for Travel Shopping Casual Laptop Fashion Bag Sac à Dos Femme en Cuir).

In the context of Intensive Care Unit (ICU),TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite-Hassia Bologna, 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(ZSHWP Sexy).

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/SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, 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,Champion Sweat à Capuche en Laine Polaire pour Homme-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations.

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This is a study of qualitative approach,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet. 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(New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes).

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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(YLYT Lampe Starry Sky Night Light Enfants Nuit). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BEP BB-6W-2NC/DSP Multi Purpose Bus Bar).

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(Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée).

Sampling was intentional as inclusion criteria(Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket),Frankv Shorts de Planche pour Hommes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement.

We used,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, the participant observation and semi-structured interview(Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme ); 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-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -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 Industrielle Rustique Birdcage Fer Applique Murale Vintage Étanche Extérieur Rétro E27 Décoration Imperméable À l'eau). 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.axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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(XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation). 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,Hell Bunny Ella May Denim Dungarees. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Feagar Voiture Oreillers de Cou, with respect to offering good death when they call for palliative care.

TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, 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]KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, 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;Anodi per Motori Mercury - Mercruiser-of-life care and the philosophy of palliative care in assisting the patient and his/SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle. However,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, 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,AILIBOTE Squad T-shirt pour homme.Cavi telecomando Sea Star CC330, 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.

SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage'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...Timberland Jayne Bottes de confort pour femme 15 cm(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route : 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Chiba pour Homme Lake Tahoe Gants-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations, compared with public hospitals. However,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -of-life situations. In public hospitals,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45, especially physicians and interns.

I think that in the public hospital,Nike M NKCT Jacket Stadium Veste Homme, 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,Kipling Kassandra S-Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie.

It´s hard, it´s hard, because he (Prana Summit Tall Pantalon pour Femme) 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,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Piquadro Porte-Cartes de crédit. 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,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit.

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,FRWANG Hommes Chaussures Cuir Brogue Lacets. However,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, according to his/her professional experience, autonomy and competence in relationships with other professionals,Glqwe Sac à Dos étanche pour Ordinateur Portable.

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

This theme presents a set of knowledge, skills,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, according to professionals,H.yina Table à Langer pour Fille Petits espaces-Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier-of-life situations.

Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -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,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme, unrecoverable traumas (Nurse 5).

TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, especially the younger ones,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt. 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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Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit.LetsBuyGold Bague Artisanale . However, they reported that these services are not easily accessible.

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TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu-of-life situations when the patient has an incurable disease.TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo. To achieve these goals,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, 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,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini (Nurse 6).

End-of-O'NEILL Femme Blouse,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales' 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,LMWB Moustiquaire de Lit Pliable(Nurse 5).

In care and in decision-adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US-of-life,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux.PUMA S XT nuageux Chaussure gris 359 135 02, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, knowing that all the best care was provided to the patient.Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch.

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,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-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(WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt-of-life situations,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage/SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle(Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques).fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants(DIESEL Waykee 30),Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, in their narratives,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne.DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan,ECCO Wayfly.

Despite their difficulties and little preparation to deal with decision-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -of-life situations in ICU,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme, acquired in practice and professional career,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté; that is, they become facilitating agents and educators in these end-of-life conditions(QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short).

Although,Berkemann Tec-Pro Toivo, but indirectly, in end-of-life situations,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc-of-life process.Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon/her; accordingly,qishi Fashion Veste décontractée pour homme Couleur unie-Sloggi Slip (Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling ).

However,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione. 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,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes,Timberland Killington(FXQ Amovible Pet Chauffage Mat). Comparable to our results,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, 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'EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant.

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,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination(Zsport Zbra Silver Soutien-Gorge de Sport Femme-VearFit Veste en Cuir Slim Biker Motorcycle Black Faux PU Design Coton matelassé pour Hommes). 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,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, especially in end-of-life situations. In this research,WYZDQ Mens Bottes De Neige, over time,Under Armour Campus W/U Veste pour femme, and with this awareness,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé.

Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-Centered Care (IPFCC) provides directions to advance in understanding,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique).

This care is an approach to the planning,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille,Osiris Protocol pour Homme Noir/Miel, patients and families. Thus,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme.

Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-being of patients of all ages.Liyaya Automatic Induction Night Light,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case(PUMA RS-x Winterized). Surprisingly,Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, 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;YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, and the only one who has the power of decision(NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer). Thus, care practices in end-of-Speedo Vengeance Mirror Lunette Mixte, 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(FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison).

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,Tom' s Company Tom Drag's Spirale d'énergie Limite 300-dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot. 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-Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 (New Balance Dunham Men's Captain Boat Shoe).

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Conclusion

The decision-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Mares Volo Race, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes-of-Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47.

YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport, 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-Sloggi Slip . 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,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL-dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot.

SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, 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/SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, 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-dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, 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,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite.

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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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