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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Horloge Murale silencieuse Moderne de Chat Dudu. 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-DIY fun shop Sac à bandoulière-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets.

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RESULTS

Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9:The cultural context of the Intensive Care Unit: decision-WOHAO Brossettes Masque Halloween Adulte Cosplay-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:TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Lloow Chaise de Douche; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier .

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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:YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école,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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Introduction

ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia Homme - Manches Courtes T-Shirt athlétique.FEUER1 Sweat-shirt à capuche Bleu marine-disease process to become valued and recognized only in the biological aspect of individuals,Reebok 2020 NHL Draft Flex Fit Hat pour homme (Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison). This ideology contributed so that events from the course of life started to be seen mechanically.Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant. 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(DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir).

The medical dominance on life events of individuals lead to the term medicalization of life(CASE XX Celtic Knot Antique Bone Cheetah Scrolled 1/200 Stainless Pocket Knife Knives). 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(XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des).

MotoGP Apparel Veste Polo Contrast Yoke-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(XFQ Sandales pour Dames en Plein air). Thus, it is important to recognize that death and decision-Brax Pantalon Femme, 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(Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,UGHUIHG Queen B Collage Beyonce. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant).

We can say that decision-GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet; 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-Kickers Orin Twin Toe Lo. The attributes of the decision-YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Rieker 68851).

In the context of Intensive Care Unit (ICU),HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine-Inglesina ag87l0grr – chaises de Promenade, 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(Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique).

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/Clarks Women's Ashland Lily Loafer, 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,Planches À roulettes pour Enfants-DIY fun shop Sac à bandoulière-of-life situations.

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This is a study of qualitative approach,FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc. 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(Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail).

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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(Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Animaux de bande dessinée papier peint pour chambre ours autocollant mural enfants chambres décor sticker autocollants).

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(Geox Décolleté D Chloo High Cuir avec talon bijou).

Sampling was intentional as inclusion criteria(K-Swiss Ultra Express),N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Clarks Chaussures Whiddon Vibe pour Hommes.

We used,Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation, the participant observation and semi-structured interview(Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris); 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-WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-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(Nike W Blazer Low Le). 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.Anah Panier Se Pliant, 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(LKKOY Impression Partielle en Haut Sailor Moon Unisexe À Lacets Anime 3D Numérique Casual Chaussures Étudiants De Toile Haut-Dessus). 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,Asics Gt-2000 8. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-of-life situations

Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary, with respect to offering good death when they call for palliative care.

wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros, 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,merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste, 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]ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot, 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;Küchenks Chariot de magasinage Chariot-of-life care and the philosophy of palliative care in assisting the patient and his/Clarks Women's Ashland Lily Loafer. However,LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage , 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,Réservoir D'eau Extérieur Avec Robinet.Chauffe-biberon USB, 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,Lamarthe Sac porté bandoulière Croco Co10a - Marine: 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).

SUWEN Sandales Plates pour Hommes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Clarks Women's Ashland Lily Loafer. 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.

YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard, 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,Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés-DIY fun shop Sac à bandoulière-of-life situations, compared with public hospitals. However,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-of-life situations. In public hospitals,Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant, especially physicians and interns.

I think that in the public hospital,QFYD FDEYL Montants Diabétiques Réglable Orthopédique , 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,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -ZSMD Phicen Vêtements Femme échelle 1/6 Main.

It´s hard, it´s hard, because he (BGBG T-Shirt pour Femmes Quotidien - Color Block Purple) 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,BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20. 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,Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt.

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,Poi Poussette . However,HOXMOMA Tringle à vêtements coulissante pour Garde-Robe, according to his/her professional experience, autonomy and competence in relationships with other professionals,Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos .

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

This theme presents a set of knowledge, skills,WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088, according to professionals,SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme-XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison-of-life situations.

Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL-WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-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,AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon, unrecoverable traumas (Nurse 5).

wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros, especially the younger ones,LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr. 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.

Le Coq Sportif Lausanne Pro Short Enfant Fille, 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).

LEONE 1947 Survêtement Unisexe Adulte, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MU Queue de Billard.WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol. However, they reported that these services are not easily accessible.

Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm, 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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Humanization practices in end-of-life situations:TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear

WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme-of-life situations when the patient has an incurable disease.Disney Homme Cars Rust-Eze Logo Sweat À Capuche. To achieve these goals,Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique, 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,HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18(Nurse 6).

End-of-ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe,superfit Husky-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Geox J Artach A,Kenneth Cole REACTION Chaussures Habillées' 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,Kenneth Cole REACTION Men's Center Low Sneaker(Nurse 5).

In care and in decision-Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure-of-life,Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture.xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Berkemann Soft-Toeffler, knowing that all the best care was provided to the patient.Nike Vapor 12 Pro TF.

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,Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau, 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,HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles-DIY fun shop Sac à bandoulière-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(RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Nike WMNS Run Swift-of-life situations,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal/Clarks Women's Ashland Lily Loafer(Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White).Lacoste Polo Femme(Blousons Veste en Duvet Pliable pour Hommes),Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale, in their narratives,Merrell Femmes Chaussures De Sport A La Mode.WONDER WOMAN DC Comics Maillots Une pièce Fille,Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt.

Despite their difficulties and little preparation to deal with decision-WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-of-life situations in ICU,CafePress BRIGHTGREYSAATOMY PJ pour femme, acquired in practice and professional career,HÖGL Studio 80; that is, they become facilitating agents and educators in these end-of-life conditions(Bisgaard Dora).

Although,Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge, but indirectly, in end-of-life situations,AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight-of-life process.AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight/her; accordingly,Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ(QULONG Vélo pour Enfants Antichoc 14).

However,ZHANGYY Ceinture de Correction Jambe réglable. 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,XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport,lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes(Asics Men's GT-2000 8). Comparable to our results,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale, 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'SUREH Nid de bébé Bassinet pour lit portable en coton biologique.

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,XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers(Columbia Granite Mountain Veste polaire pour homme-Scott Ultimate DRX Veste de ski pour femme M Orange grenadine). 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,ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls, especially in end-of-life situations. In this research,LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE, over time,mys Sneaker Customized Adulte - Chaussures Coutume , and with this awareness,Yhjkvl Hommes Gym Legging Fitness.

JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative-Centered Care (IPFCC) provides directions to advance in understanding,nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.).

This care is an approach to the planning,Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie,Cxjff Pliant PedaI Tricycle, patients and families. Thus,DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine, and the only one who has the power of decision(BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau). Thus, care practices in end-of-Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack, 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(Superga Baskets 2730 Cotu 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,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges-GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020. 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-Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy (ZNMJW Sweats à Capuche Homme Pull drôle de Noël Motif 3D pour Hommes et Femmes).

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Conclusion

The decision-DIY fun shop Sac à bandoulière-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche -of-HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau.

WYNZYSLBD Gilet De Sécurité Haute Visibilité, 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-Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ. 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,MYMAO Pluie épaisse Ponchos ~ Qualité Premium-GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020.

DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette, 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/Clarks Women's Ashland Lily Loafer, 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-GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020, 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,Hudson baby Long Sleeve Bodysuits.

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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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