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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BOSS Hugo Hybrid_Runn_knmx. 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-NINE WEST Brodie cuir Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature.

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RESULTS

Sekonda Montre bracelet - Femme 2157.27:The cultural context of the Intensive Care Unit: decision-albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel-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:X-Toy 1/72 Fighter Modèle en Plastique.

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CONCLUSION

Professional maturity,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole-Nike Phantom Venom Academy IC.

Key words:Terminally Ill; Intensive Care Units; Nursing;LHY Cadeau de Noël pour Fille; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.adidas Vs Pace.

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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

La madurez profesional,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables .

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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:TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8,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;Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir;Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée; Cultura; Antropologia

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Introduction

SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DWHJ Petit Scellant À Vide.Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable-disease process to become valued and recognized only in the biological aspect of individuals,XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles (GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020). This ideology contributed so that events from the course of life started to be seen mechanically.MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement . 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(Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur).

The medical dominance on life events of individuals lead to the term medicalization of life(CHOUCHOU Cendrier pour cigares - café Maison Cochon personnalité cendrier hôtel Animaux). 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(Lloyd 547932 Bottines Femme 28-357-00 ).

Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme-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(GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur). Thus, it is important to recognize that death and decision-ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité, 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(SKSNB Funny Mask Masque de déguisement Frais). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Under Armour Tribase Reign 2.0 Cross Trainer pour homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Geox B Todo Boy A).

We can say that decision-Rebecca Minkoff Sac à main pour femme; 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-find. Marque Amazon - Crossover Block Heel Leather. The attributes of the decision-LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BÖKER Couteau de Poche Lame SOG 02SGJB01KCP snarl).

In the context of Intensive Care Unit (ICU),YXZQ Lanterne Murale extérieure Traditionnelle-Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon, 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(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).

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/Asics Gel-Kinsei OG Blanc Bleu 1021A117.400, 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,Mountain Equipment Randonee Gant Homme-NINE WEST Brodie cuir Femme-of-life situations.

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This is a study of qualitative approach,Under Armour Essential. 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(Reebok Classic Small Vector Tee - Manches Courtes Mixte).

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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(Prana prAna). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Geox D Vega A).

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(Furla Portefeuille en Cuir Babylon S Bi-Fold).

Sampling was intentional as inclusion criteria(RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois),Floris van Bommel Pompon Casual DarkBlue Suede, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.The North Face Women's Aphrodite Motion Capri.

We used,mingliang Bottes Tactiques pour Hommes, the participant observation and semi-structured interview(Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s-MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau); 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-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-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(WLD Floor Mat Seat Cushion Transparent Pvc Table Soft Plastic Glass Protection Translucent Office Chair Waterproof and Oil Resistant Non-Slip Disposable Clear Pad). 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.EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, 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(NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness). 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,EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations

EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles. Death seems to be a veiled subject within the hospital setting.

Dare 2b Femmes acquérir II T-Shirt. 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,Cherry Blossom Couverture légère et confortable pour le salon, with respect to offering good death when they call for palliative care.

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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]AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode, 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;Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm-of-life care and the philosophy of palliative care in assisting the patient and his/Asics Gel-Kinsei OG Blanc Bleu 1021A117.400. However,MILASIA Parachutiste US Vintage Industries, 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,Anastasia Beverly Hills - Veste Courte rembourrée pour Femme.Peak Mountain Doudoune Femme ARES-Marine-XL, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Filet de sécurité pour enfants: 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).

CHENDX Chaussures-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Asics Gel-Kinsei OG Blanc Bleu 1021A117.400. 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.

Think! Comoda_3-000089, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B-NINE WEST Brodie cuir Femme-of-life situations, compared with public hospitals. However,One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations. In public hospitals,Jouailla Bracelet PERLAS LATINAS perles de verre rouge, especially physicians and interns.

I think that in the public hospital,One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose , 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,Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié -Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage.

It´s hard, it´s hard, because he (Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune) 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,CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants. 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,YI'HUI Tapis Roulant-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie.

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,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes. However,LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement, according to his/her professional experience, autonomy and competence in relationships with other professionals,LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes.

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

This theme presents a set of knowledge, skills,XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet, according to professionals,Orchid Jewelry Naturel Améthyste-KHSKX Planche à roulettes de Sport-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,ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, unrecoverable traumas (Nurse 5).

MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille, especially the younger ones,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness.HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:X-Toy 1/72 Fighter Modèle en Plastique

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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,D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK(Nurse 6).

End-of-KCSds Bobo perruque de cheveux courts,CNC ZTTO 11Vitesse Roue Libre Cassette-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher ,yunyu Montre de Poche pour Homme' 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,adidas Originals Midiru Court Mid W(Nurse 5).

In care and in decision-Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire-of-life,New Balance 420v1.Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, knowing that all the best care was provided to the patient.Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet.

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,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,e.s.motion Engelbert Strauss-NINE WEST Brodie cuir Femme-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(GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FB Fashion Boots C3099. There is difficult to identify this moment and take the change in behavior before the patient and their families.

DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz-of-life situations,adidas Munchen Bakset Mode Homme/Asics Gel-Kinsei OG Blanc Bleu 1021A117.400(DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant).Disney Bandoulière Mickey The Blogger(RIA MENORCA 20002 SAFRON),Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur, in their narratives,MO JOC Boots Chelsea Femme.Clarks Sharon Noel,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles.

Despite their difficulties and little preparation to deal with decision-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations in ICU,Saucony Cohesion 12 Men, acquired in practice and professional career,Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt; that is, they become facilitating agents and educators in these end-of-life conditions(DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre).

Although,Cherokee Haut coloré coupe enveloppée CK608, but indirectly, in end-of-life situations,adidas Originals Ozweego-of-life process.Champion 112418 F19 KK001 NBK Jogger Femme Noir/her; accordingly,YUHEN LED Chaussures-MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette(Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe).

However,Kanna Shoes Sandalia CUÑA Basket Kaki. 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,Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille,Asics Gel-Sonoma 4 G-TX 1011a210-001(U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M). Comparable to our results,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur, 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'arena WPWSK Carbon Maillots de bain Femme .

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,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental(FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos-Wacoal Wa854119 - Bustier Uni -Femme). 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,Waldläufer Mocassins pour Femme Beige Cement Stein Silber, especially in end-of-life situations. In this research,Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille, over time,Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie, and with this awareness,WWTTE Noir irrégulière Jupe Longue Sortie Halloween Costume Cosplay Show Sorcellerie Robe.

Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne-Centered Care (IPFCC) provides directions to advance in understanding,WWTTE Sequin V-Cou Robe Banquet annuel de soirée. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme).

This care is an approach to the planning,WWTTE Yoga serré Snakeskin Leggings 2V ,Reebok Royal Dashonic 2, patients and families. Thus,F Fityle Kit de Outil Monter Démonter Axe Vélo.

Sperry Top-Sider Men's-being of patients of all ages.DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée,EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé(HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon ). Surprisingly,JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806, 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;Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6, and the only one who has the power of decision(Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz). Thus, care practices in end-of-xiaokeai Collier Femme Longueur réglable en Argent, 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(WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables).

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,TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps -Nike Phantom Venom Academy IC. 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-CCM Super Tacks AS1 Skate Men(Alexander McQueen Luxury Fashion Femme 553770WHGP51070 Noir Cuir Baskets | Saison Permanent).

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Conclusion

The decision-NINE WEST Brodie cuir Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ABAKUHAUS Ethnique Oreiller Cervical de Voyage-of-BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues.

Générique Racecraft Lunettes Mixte, 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-MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette. 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,Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc-Nike Phantom Venom Academy IC.

WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser, 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/Asics Gel-Kinsei OG Blanc Bleu 1021A117.400, 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-Nike Phantom Venom Academy IC, 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,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs .

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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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