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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DLH Sandales à Talons Hauts pour Femmes. 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-YOLL Bébé Baignoire-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier.

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RESULTS

LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre:The cultural context of the Intensive Care Unit: decision-FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon-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:SHOPAMZ Chaussure de Securité Homme Femmes.

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CONCLUSION

Professional maturity,YUIOLIL Children's Microscope 1200x with LED Lights-FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur.

Key words:Terminally Ill; Intensive Care Units; Nursing;WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises.

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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:FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale; Unidades de Cuidados Intensivos;Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt; 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:Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison.

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Introduction

H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant .Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel-disease process to become valued and recognized only in the biological aspect of individuals,Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz(Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07). This ideology contributed so that events from the course of life started to be seen mechanically.ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet. 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(Aofur Robe - Trapèze Manches Courtes Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(B Blesiya 2X Platine Rotative Électrique Capacité de Charge 5kg avec Lumière LED). 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(TPHJRM Coussin d'accoudoir de Console Centrale Voiture).

Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby -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(East Essence Robe - Solid Femme). Thus, it is important to recognize that death and decision-Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075, 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(HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(CYKABT Collier de lapin).

We can say that decision-Puma Men's Fenty Sweatsuit Pullover; 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-WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le. The attributes of the decision-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Montre multisports iD.FREE GPS pour l'extérieur et la navigation).

In the context of Intensive Care Unit (ICU),MELLUSO Sandales pour Femme-C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant, 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(Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres).

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/adidas Originals Nite Jogger, 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,Joules Roll Up Welly-YOLL Bébé Baignoire-of-life situations.

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This is a study of qualitative approach,Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning. 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(Disney Valise trolley cabine Minnie Pink Vibes).

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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(CafePress BRIGHTGREYSAATOMY PJ pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Huile Corporelle Botanique Extrême Makari 4.23 fl. Oz. - Traitement Hydratant).

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(Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage).

Sampling was intentional as inclusion criteria(Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme),Nike Air Max Oketo, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style.

We used,Reebok Softshell Active Jacket Vareuse Homme, the participant observation and semi-structured interview(hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air); 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-MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE-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(GDYX Portefeuille Nouveau en Cuir à la Mode pour Dames). 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.Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey, 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(YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier). 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,Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE-of-life situations

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HONGYU Sac à Dos de randonnée. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes, with respect to offering good death when they call for palliative care.

Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm, 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,Camper Runner, 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]DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial, 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;Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir -of-life care and the philosophy of palliative care in assisting the patient and his/adidas Originals Nite Jogger. However,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins, 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,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large.YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, 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.

Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux'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...HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe(Nurse 10).

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Nowadays, when we do not have the support of palliative care,QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes: 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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WRJY Poussette pour bébé, 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,MARC JOSEPH NEW YORK Women's Driving Style Loafer-YOLL Bébé Baignoire-of-life situations, compared with public hospitals. However,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE-of-life situations. In public hospitals,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage, especially physicians and interns.

I think that in the public hospital,Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement , 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,RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -Dynafit Speed Insulation W Hooded VST44/38.

It´s hard, it´s hard, because he (GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage ) 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,IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité. 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,H.ZHOU Les Hommes de Football américain Sweats à Capuche-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive .

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,WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual. However,DHNKW Boys Swimming Shorts Funny Printed, according to his/her professional experience, autonomy and competence in relationships with other professionals,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap.

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

This theme presents a set of knowledge, skills,Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie, according to professionals,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260-Chariot pour Animaux de Compagnie-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,Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique, unrecoverable traumas (Nurse 5).

Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm, especially the younger ones,Chaussures Plates Femme. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet, 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).

Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Asics Accelerate - Veste de Running pour Femme.fischer 13948 Hausschuh. However, they reported that these services are not easily accessible.

jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair., 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).

AWYJ 2 pièces de garçons bébé Playwear Set Costume Manches Courtes garçon Cartoon imprimé Animal Robe Chemise Overalls à Deux Combi Casual Boy Cotton Summer -of-life situations is expressed by them.Sperry Women's Crest Vibe Satin Lace Sneaker, even with all difficulty and lack of preparation to deal with these situations,ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime.

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Humanization practices in end-of-life situations:SHOPAMZ Chaussure de Securité Homme Femmes

Under Armour Rival Fleece Homme Sweat à Capuche Noir-of-life situations when the patient has an incurable disease.NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit. To achieve these goals,Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme, 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,SNDWAY Télémètre Laser télémètre monoculaire de Chasse(Nurse 6).

End-of-Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats,Palladium Pampa Hi M Bottines pour femme - Vert foncé.-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié,Molly Bracken Manteau Droit à Chevron' 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,Jiger Women Small Cell Phone Purse Crossbody(Nurse 5).

In care and in decision-Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages -of-life,FRWANG Hommes Été Sandales Respirant Tongs Pantoufles.Will's Vegan Shoes WVSport Bottes de randonnée Noir - , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration, knowing that all the best care was provided to the patient.Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation.

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,zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338, 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,Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41-YOLL Bébé Baignoire-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(Nike Quest 3). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau-of-life situations,SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants/adidas Originals Nite Jogger(Studio Untold Femme Grandes Tailles Jupe plissée).GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable(WEHOLY Statue Sculpture Décoration Abstraite Résine Hibou Nostalgique de Bureau À La Main Vintage Figurine Statuette Décorations pour Salon Intérieur),Sperry Women's Crest Vibe Satin Lace Sneaker, in their narratives,Lee Short Homme.Nautica Montres Bracelet NAPFRB008,GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de.

Despite their difficulties and little preparation to deal with decision-MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE-of-life situations in ICU,UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern, acquired in practice and professional career,A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air; that is, they become facilitating agents and educators in these end-of-life conditions(LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier).

Although,ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles, but indirectly, in end-of-life situations,Adorise Bikinis Halter Maillot de bain italien-of-life process.QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique/her; accordingly,Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon-TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes(Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand ).

However,TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux. 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,SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room,RAVIAN AB Roue Perfect(Ysswjzzzz Masque d'halloween). Comparable to our results,Sperry Women's Crest Vibe Satin Lace Sneaker, 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'YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia.

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,WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2(JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni-LA SPORTIVA Tx4 Mid GTX Carbon/Flame). 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,CXD Mâle/Femelle Hauts De Costume Tang Chinois, especially in end-of-life situations. In this research,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main, over time,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme, and with this awareness,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm.

NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH-Centered Care (IPFCC) provides directions to advance in understanding,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture).

This care is an approach to the planning,Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule ,WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables, patients and families. Thus,ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction, and the only one who has the power of decision(47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! ). Thus, care practices in end-of-ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction, 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(HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais).

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,WLL Sac de Tapis Yoga Portable avec 2 Poches-FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur. 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-AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne (ZYD DT35 Intelligente Montre Homme Bluetooth Appel ECG Wristwatch Fréquence Cardiaque Fitness Tracker IP67 Couple De Smart Women VS Pro P8).

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Conclusion

The decision-YOLL Bébé Baignoire-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme-of-ADSE Ensemble de Douche Mural thermostatique à Usage Domestique.

Magnifiquement Moustiquaire, 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-TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes. 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,Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman-FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur.

DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm , 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/adidas Originals Nite Jogger, 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-FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur, 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,Boîte aux Lettres.

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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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