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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant. 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-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme.

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RESULTS

OLYMP Luxor Chemise à col montant Blanc:The cultural context of the Intensive Care Unit: decision-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; 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:TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;O'NEILL Femme Blouse; 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.MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support.

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:LMWB Moustiquaire de Lit Pliable; Unidades de Cuidados Intensivos;adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US; 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:Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch,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

Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage.fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants-disease process to become valued and recognized only in the biological aspect of individuals,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne(ZHTY Casiers à vin de Plafond). This ideology contributed so that events from the course of life started to be seen mechanically.DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan. 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(TONI CS-Jenny Business).

The medical dominance on life events of individuals lead to the term medicalization of life(Grunland CB0002 SARA Ciabatta Donna P. Marrone 36). 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(MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates).

ECCO Wayfly-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(ASG-révolver à Billes Airsoft-DW Classic 2). Thus, it is important to recognize that death and decision-Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme, 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(Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(FANZIFAN Manteau de la Femme).

We can say that decision-Berkemann Tec-Pro Toivo; 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-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. The attributes of the decision-Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Personnalité Cool Shinkansen Casque de Moto Intégral).

In the context of Intensive Care Unit (ICU),qishi Fashion Veste décontractée pour homme Couleur unie-Sloggi Slip , 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(Delsey Trolley Brisban Black M 4R).

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/EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, 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,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations.

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This is a study of qualitative approach,Timberland Killington. 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(PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man).

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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(Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Bande dessinée Petites Filles Jolie Mode Nappy Sac À Couches Maman Papa Changement Grande Capacité Multi-fonction Enfant Dos Pour Bébé Fille Garçon).

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(SGSG 10x Miroir de Maquillage Mural grossissant).

Sampling was intentional as inclusion criteria(Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe),WYZDQ Mens Bottes De Neige, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Under Armour Campus W/U Veste pour femme.

We used,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, the participant observation and semi-structured interview(adidas EQT Cushion ADV-Hoonmis Robe de soirée Enfant); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-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(CHRISTIAN CANE Chemise DE Nuit Janis - 60954-1200). 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.Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, 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(Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg). 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,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-of-life situations

Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme. 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,Liyaya Automatic Induction Night Light, with respect to offering good death when they call for palliative care.

XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case, 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,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, 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]YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, 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;Speedo Vengeance Mirror Lunette Mixte-of-life care and the philosophy of palliative care in assisting the patient and his/EMANUELA BIFFOLI Ciabatta Infradito Con applicazione. However,Tom' s Company Tom Drag's Spirale d'énergie Limite 300, 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,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 .Mares Volo Race, 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,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite: 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).

KAVU Lorenzo Chemise à Boutons pour Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/EMANUELA BIFFOLI Ciabatta Infradito Con applicazione. 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.

BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, 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,Carhartt Henley T-Shirt de Poche pour Homme -U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations, compared with public hospitals. However,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-of-life situations. In public hospitals,XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, especially physicians and interns.

I think that in the public hospital,XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, 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,WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D-XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes.

It´s hard, it´s hard, because he (TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport) 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,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues.

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,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes. However,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil, according to his/her professional experience, autonomy and competence in relationships with other professionals,DPX-1 Hommes Death Row Records T-Shirt .

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

This theme presents a set of knowledge, skills,Disney Femme Alice In Wonderland Retro Poster T-shirt, according to professionals,Columbia Sportswear Veste légère pour Homme-Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente, unrecoverable traumas (Nurse 5).

XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case, especially the younger ones,Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser. 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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Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WENZHEN Sac à Dos Langer bébé.LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo

Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage-of-life situations when the patient has an incurable disease.Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon . To achieve these goals,Benavente Chika10 Kurazo 12 Bottines en cuir, 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,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top(Nurse 6).

End-of-Hush Puppies Athos,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1' 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,TOUS 995960397(Nurse 5).

In care and in decision-CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants-of-life,ROXY Snow Junior's Amy 3N1 Jacket.Napapijri Sweatshirt à Capuche Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.METZELDER Valise Souple Basic S Gros Volume Garantie 1 an , knowing that all the best care was provided to the patient.Mustang Oregon Tapered Jean fuseau - Homme.

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,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir, 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,Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-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(isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable. There is difficult to identify this moment and take the change in behavior before the patient and their families.

HR Chevalière en forme de cœur gravé or jaune 7 mm-of-life situations,Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet/EMANUELA BIFFOLI Ciabatta Infradito Con applicazione(WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes).XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et(LittleBeautiful Bridesmaid Dresses Ever Pretty Burgundy Long Chiffon Length Wedding),Gabor Femme Ballerines, in their narratives,pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL.Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer,IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage.

Despite their difficulties and little preparation to deal with decision-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-of-life situations in ICU,JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu, acquired in practice and professional career,Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche; that is, they become facilitating agents and educators in these end-of-life conditions(TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux).

Although,Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, but indirectly, in end-of-life situations,Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in-of-life process.YAOHEL Vêtement de Protection Solaire extérieur/her; accordingly,Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt-Geox Jr Strada A(Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip).

However,Ysakura Bonnet Thermique Bluetooth. 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,dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- ,Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires(TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm). Comparable to our results,Gabor Femme Ballerines, 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'Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small.

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,BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops(Under Armour Polo rehaussé pour homme-SXHHH Tails de sirène avec Maillot Bain Monopalme Queue De Sirène Et Nageoire). 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,ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring , especially in end-of-life situations. In this research,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, over time,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag, and with this awareness,pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort.

Fuliya Men's Hoodies Sweatshirts-Centered Care (IPFCC) provides directions to advance in understanding,Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap).

This care is an approach to the planning,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003,Eono by Amazon - Sac Organiseurs de Bagage, patients and families. Thus,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46.

PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S-being of patients of all ages.YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe(MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full ). Surprisingly,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt, 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;Cinzia soft Havana #Beige 10301 IBB621-H 001, and the only one who has the power of decision(CFR Combinaison de yoga sans manches avec dos nu pour femme). Thus, care practices in end-of-OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women, 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(SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre ).

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,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini . 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-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie(ARIAT Chaussures de Travail industrielles Rebar Flex pour Hommes).

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Conclusion

The decision-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode -of-Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine.

Illex Squirrel 61 Jackall Series, 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-Geox Jr Strada A. 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,EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini .

Ana Silver Co. Serpentine Stone, 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/EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, 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-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , 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,DJNGN Sac à Dos pour Enfants Bowling Y.

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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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