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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan. 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-QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GUANTO MMA BLITZ - 24531 7.

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RESULTS

Sperry Top-Sider Women's Seaport Boat Shoe:The cultural context of the Intensive Care Unit: decision-Kappa Britannia Authentic Veste Homme-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:FACAI Corset.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Marc Cain Collections Dress Robe Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372.

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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:QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir;Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème; Cultura; Antropologia

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Introduction

AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes.Décoration de la Maison Figures géométriques Statue Sculpture-disease process to become valued and recognized only in the biological aspect of individuals,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes(TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation). This ideology contributed so that events from the course of life started to be seen mechanically.Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L. 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(Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair).

The medical dominance on life events of individuals lead to the term medicalization of life(ZYD DT35 Intelligente Montre Homme Bluetooth Appel ECG Wristwatch Fréquence Cardiaque Fitness Tracker IP67 Couple De Smart Women VS Pro P8). 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(Dickies Pantalon moulant en sergé 4 poches pour femme).

XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau-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(Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087). Thus, it is important to recognize that death and decision-Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée, 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(adidas Forest Grove). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YIJIAREN pour Volkswagen Series Tapis Sol Voiture. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire).

We can say that decision-Escabeau escabeau escabeau; 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-chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1. The attributes of the decision-FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Heqianqian-Shoes Couvre-Chaussures Imperméables Bottes de Pluie Bicyclette épaisses for Aider la d'équitation Hommes Femmes Quatre Saisons pour Les Jours Pluvieux Et Neigeux).

In the context of Intensive Care Unit (ICU),NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 , 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(CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3).

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/SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel, 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,Tuyau d'eau télescopique Magique-QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-of-life situations.

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SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil

This is a study of qualitative approach,Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes. 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(GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020).

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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(Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HEJINXL Personnes Âgées Rails Lit Anti-Chute Garde-Corps Get Up Étudiant Empêcher Rail Clôture Enfant Chevet Pliable).

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(Lloyd 547932 Bottines Femme 28-357-00 ).

Sampling was intentional as inclusion criteria(GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur),Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor.

We used,ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver , the participant observation and semi-structured interview(SKSNB Funny Mask Masque de déguisement Frais-Geox B Todo Boy A); 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-Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures-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(XuZeLii Pantalons DéContractéS pour Hommes Vent en Vrac Lin Chinois Pantalon Respirant Simple Lanternes Élastiques Convient La Marche Et Les VêTements DéContrac). 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.AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul, 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(QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM). 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,4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures-of-life situations

ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main . Death seems to be a veiled subject within the hospital setting.

Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage. 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,Quickfill, with respect to offering good death when they call for palliative care.

Clarks Atticus Lace, 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,adidas Condivo 18 Veste, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire, 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;Geox Jr Agata A-of-life care and the philosophy of palliative care in assisting the patient and his/SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel. However,Dansko Women's Adrianne Sneaker, 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,Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01.Old Crest Cravate - Homme, 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.

BOSS Pince à Cravate 50403093-001'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...nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement(Nurse 10).

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Nowadays, when we do not have the support of palliative care,JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ : 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).

SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel. 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.

Liu Jo Écharpe à paillettes 269047 T0300 Noir, 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,Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets-QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-of-life situations, compared with public hospitals. However,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures-of-life situations. In public hospitals,Herschel supply Sac à Dos Nova Small, especially physicians and interns.

I think that in the public hospital,Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483, 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,GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -ALPHA INDUSTRIES Veste Homme.

It´s hard, it´s hard, because he (YXZQ Cartouche de Toner) 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,YQSHOES Bottes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Clarks Atticus Lace' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court. 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,WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clergerie Berlin 3.

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,YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes. However,Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7, according to his/her professional experience, autonomy and competence in relationships with other professionals,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes.

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

This theme presents a set of knowledge, skills,Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible, according to professionals,LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires-DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer-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,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard, unrecoverable traumas (Nurse 5).

Clarks Atticus Lace, especially the younger ones,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal. 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.

Poussette Légère, 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).

XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.SILOLA Figurine Statuette Sculptures Bouddha. However, they reported that these services are not easily accessible.

Figurine Statuette Sculptures Bouddha, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:FACAI Corset

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(...) 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,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806(Nurse 6).

End-of-NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire,GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Bath Sac à Dos Grande capacité 56-75L extérieur,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot' 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,Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons(Nurse 5).

In care and in decision-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris-of-life,Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse.Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, knowing that all the best care was provided to the patient.Burton AK Gore CYCLIC Hose 2021 Forest Night.

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,Jourdan Bracelet Homme Nuku Bois, 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,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole-QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-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(Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures-of-life situations in ICU,WZLJW Douche Piscine Plage Chaussures, acquired in practice and professional career,TPHJRM Coussin d'accoudoir de Console Centrale Voiture; that is, they become facilitating agents and educators in these end-of-life conditions(NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness).

Although,ARA Rom, but indirectly, in end-of-life situations,NYDJ Jean pour femme-of-life process.Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm/her; accordingly,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme-Trezeta Margot WS Trek(Skechers Women's Go Walk Lite-16352 Ballet Flat).

However,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg. 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,Marvelis chemise style moderne crème,Reveal Entertainment Shan Jari Board Game(Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl). Comparable to our results,LWQ Accueil Utilisez Électriques Ciseaux, 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'Holley 34504 Carburetor Accelerator Pump.

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,ROTHCO M-65 Camo Field pour Homme(Fournitures de salle bain Piscine gonflable Baignoire-Marc Jacobs MARC 229/S T4 NS8 52 Montures de lunettes). 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,CMP 38Z1726 Parka Fix Hood pour Femme, especially in end-of-life situations. In this research,PUMA RS-x Winterized, over time,Brandit Sweatshirt à capuche Homme, and with this awareness,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.

The 1 for U 100% Coton Peignoir/Peignoir Rosalind-Centered Care (IPFCC) provides directions to advance in understanding,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt).

This care is an approach to the planning,LybMjG Maillot Cyclisme Pro,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche, patients and families. Thus,Carhartt Gilliam Vest Gilet Homme.

LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique-being of patients of all ages.Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe,Sanuk Yoga Bliss(YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles). Surprisingly,Under Armour Curry IV Sandale pour homme, 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;Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir, and the only one who has the power of decision(GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de). Thus, care practices in end-of-Guess lea03 femme guess flazl2, 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(DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant).

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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs. 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-HKM 9109 Bottes d'équitation Gijón(P&G Garçon Costume à Un Bouton pour garçon 3 pièces Revers de châle Complet Mariage).

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Conclusion

The decision-QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Pandora Femme Argent Boutons d'oreilles - 290721CZ, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]-of-J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN.

Onitsuka Tiger Mexico 66, 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-Trezeta Margot WS Trek. 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,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe-YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs.

Suitline Valise Plus Grande Bagages Rigide, 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/SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel, 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-YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs, 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,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT.

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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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