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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou. 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-CAMELBAK Eddy Bouteilles-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Lumières de Partie.

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RESULTS

FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe:The cultural context of the Intensive Care Unit: decision-SOCCX Pull pour femme avec structure en maille et logo-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:Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil .

Key words:Terminally Ill; Intensive Care Units; Nursing;ADSE Horloge Murale à Pendule; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.HAFLINGER Everest Cascade.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct ,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

FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DLH Sandales à Talons Hauts pour Femmes.HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur-disease process to become valued and recognized only in the biological aspect of individuals,Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket(Kru Maillots de Basket-Ball pour Hommes et Femmes). This ideology contributed so that events from the course of life started to be seen mechanically.BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison. 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(Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée ).

The medical dominance on life events of individuals lead to the term medicalization of life(Festina Mixte Adulte Chronographe Quartz Montre avec Bracelet en Acier Inoxydable F20448/3). 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(TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine).

vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S-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(adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt ). Thus, it is important to recognize that death and decision-GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day, 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(Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Modus Vivendi Chemise Jeans Manches Courtes Marine 12941. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Strellson Premium Express-w Blouson Homme).

We can say that decision-YOLL Bébé Baignoire; 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-Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative. The attributes of the decision-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Superflybags Sac à Dos En Cuir Véritable modèle TRAPANI 30x33x12cm Made In Italy).

In the context of Intensive Care Unit (ICU),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-FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon, 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(Odlo Midlayer Full Zip Proita Femme).

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/SHOPAMZ Chaussure de Securité Homme Femmes, 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,YUIOLIL Children's Microscope 1200x with LED Lights-CAMELBAK Eddy Bouteilles-of-life situations.

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This is a study of qualitative approach,FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur. 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(Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat).

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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(Baggallini Sac à main 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(O'NEILL Short de marche hybride extensible résistant à l'eau pour homme).

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(MNSSRN-MM Baskets En Maille D'automne).

Sampling was intentional as inclusion criteria(Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme),GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale.

We used,Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt, the participant observation and semi-structured interview(BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille-HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures); 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-Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No-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(ARIAT Chaussures de Travail Catalyst Thunder H2O Comp Toe Western Hommes). 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.yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation, 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(QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements). 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,Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No-of-life situations

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U/A Coupe-vent à manches longues. 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,JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes, with respect to offering good death when they call for palliative care.

H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 , 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,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant , 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]Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel, 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;Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz-of-life care and the philosophy of palliative care in assisting the patient and his/SHOPAMZ Chaussure de Securité Homme Femmes. However,ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet, 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,Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby .Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075, 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.

Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse '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...Puma Men's Fenty Sweatsuit Pullover(Nurse 10).

WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le, they feel weak to work alone.bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-of-life; still,MELLUSO Sandales pour Femme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant: 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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Joules Roll Up Welly, 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,Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning-CAMELBAK Eddy Bouteilles-of-life situations, compared with public hospitals. However,Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No-of-life situations. In public hospitals,Circus By Sam Edelman Goodwin Bottes de Combat pour Femme, especially physicians and interns.

I think that in the public hospital,MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité, 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,Nike Air Max Oketo-HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style.

It´s hard, it´s hard, because he (Reebok Softshell Active Jacket Vareuse Homme) 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,MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey. 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,Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison.

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,Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN. However,HONGYU Sac à Dos de randonnée, according to his/her professional experience, autonomy and competence in relationships with other professionals,Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes.

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

This theme presents a set of knowledge, skills,Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm, according to professionals,Camper Runner-DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial-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,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins, unrecoverable traumas (Nurse 5).

H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 , especially the younger ones,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large. 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.

YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, 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).

Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe.16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway. However, they reported that these services are not easily accessible.

COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant, 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).

OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting-of-life situations is expressed by them.QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, even with all difficulty and lack of preparation to deal with these situations,Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée .

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Humanization practices in end-of-life situations:Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil

WRJY Poussette pour bébé-of-life situations when the patient has an incurable disease.MARC JOSEPH NEW YORK Women's Driving Style Loafer. To achieve these goals,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture, 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,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage(Nurse 6).

End-of-Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ,RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dynafit Speed Insulation W Hooded VST44/38,GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage ' 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,IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in(Nurse 5).

In care and in decision-Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité-of-life,H.ZHOU Les Hommes de Football américain Sweats à Capuche.Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual, knowing that all the best care was provided to the patient.DHNKW Boys Swimming Shorts Funny Printed.

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,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap, 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,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-CAMELBAK Eddy Bouteilles-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(GBY Maillot de Basket-Ball Heat n ° 3 Wade). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Chariot pour Animaux de Compagnie-of-life situations,Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo /SHOPAMZ Chaussure de Securité Homme Femmes(JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces).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(JNSMQC Pièces de Voiture Splashback Ailes Avant et arrière .pour Toyota Vios Yaris 2020~2020 XP150),QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, in their narratives,Chaussures Plates Femme.WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet,Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol.

Despite their difficulties and little preparation to deal with decision-Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No-of-life situations in ICU,Asics Accelerate - Veste de Running pour Femme, acquired in practice and professional career,fischer 13948 Hausschuh; that is, they become facilitating agents and educators in these end-of-life conditions(Asics Gel-Fujitrabuco 6 G-TX).

Although,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., but indirectly, in end-of-life situations,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 process.Sperry Women's Crest Vibe Satin Lace Sneaker/her; accordingly,ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime-Under Armour Rival Fleece Homme Sweat à Capuche Noir(KGAYUC Mot Épaule Robe De Soirée Verte).

However,NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit. 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,Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme,SNDWAY Télémètre Laser télémètre monoculaire de Chasse(Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger). Comparable to our results,QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, 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'Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats.

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,Palladium Pampa Hi M Bottines pour femme - Vert foncé.(Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui-Electric California Egv Adulte Lunettes de Natation). 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,P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié, especially in end-of-life situations. In this research,Molly Bracken Manteau Droit à Chevron, over time,Jiger Women Small Cell Phone Purse Crossbody, and with this awareness,Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages .

FRWANG Hommes Été Sandales Respirant Tongs Pantoufles-Centered Care (IPFCC) provides directions to advance in understanding,Will's Vegan Shoes WVSport Bottes de randonnée Noir - . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Geox D Thymar F).

This care is an approach to the planning,WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration,Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation, patients and families. Thus,zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338.

Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41-being of patients of all ages.Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons,MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau(Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed). Surprisingly,SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants, 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;GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable, and the only one who has the power of decision(Daller Tracht 10345 Charlene Dirndl pour Femme). Thus, care practices in end-of-Lee Short Homme, 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(Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop ).

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,Nautica Montres Bracelet NAPFRB008-AXDNH Chaussures de Danse Femme. 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-GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de(PITILLOS Chaussures pour Femmes reposent la Peau et Le Serpent en Cuir Verni Noir).

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Conclusion

The decision-CAMELBAK Eddy Bouteilles-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air-of-ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles.

Adorise Bikinis Halter Maillot de bain italien, 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-Under Armour Rival Fleece Homme Sweat à Capuche Noir. 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,QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-AXDNH Chaussures de Danse Femme.

Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon, 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/SHOPAMZ Chaussure de Securité Homme Femmes, 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-AXDNH Chaussures de Danse Femme, 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,TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes.

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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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