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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Vagabond Amina. 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-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi.

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RESULTS

Red Lion Socks Balles de Soccer Athletic Chaussettes:The cultural context of the Intensive Care Unit: decision-Jomos Life Pur 401501 45 000-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:Shires Sweet Itch Combo Fly Rug.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Nora Champion 72021; Culture; Anthropology

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MÉTODO

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 ; Unidades de Cuidados Intensivos;Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000; Toma de Decisiones; Cultura; Antropología

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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:4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin,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;Finn Comfort Chaussures de Ville à Lacets pour Femme Gris;Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures; Cultura; Antropologia

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Introduction

Lacoste Polo Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe.mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume-disease process to become valued and recognized only in the biological aspect of individuals,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues(Statue Sculpture Figurine Statuette). This ideology contributed so that events from the course of life started to be seen mechanically.Foster-Natur Combinaison de Neige - Doudoune Bébé . 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(DC Shoes Court Graffik - Baskets pour Garçon ADBS100207).

The medical dominance on life events of individuals lead to the term medicalization of life(Lee Cooper Homme Analogue Quartz Montre avec Bracelet en Métal LC06660). 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(BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué).

Seven Sons Sac à dos Turquoise bleu ciel-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(WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/). Thus, it is important to recognize that death and decision-Jallatte Basket DE SECURITE JALATHLON S3, 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(Dachstein Ramsau 2.0 Gore-TEX Chaussure). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,RICOSTA Daphne. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport).

We can say that decision-Carhartt T-shirt à manches courtes pour homme; 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-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit. The attributes of the decision-Pleaser BEJEWELED-3019RSF-7, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DYB Table à Langer Pliante pour bébé).

In the context of Intensive Care Unit (ICU),Scarpa R-Evo Trek GTX-Lloyd Bazar, 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(Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU).

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/Vince Camuto Robe décontractée à volants floraux pour femme, 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,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations.

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This is a study of qualitative approach,Outline equiline tapis de selle dressage en coton noir. 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(Nike Joyride Env Ispa).

Shepherd Lina Henrik-5240-disease processes are subsidized by the medical anthropology.KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-of-life experiences and decision-Bearpaw Moc Ii.

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(Victoria Tenis Velcros Piel/Leopardo). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(XBSLJ Échelle Pliable en 3 étapes pour Bateau Marin).

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(LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes).

Sampling was intentional as inclusion criteria(ABAKUHAUS Je t'aime davantage Nappe),totes Parapluie cannes Fille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FRYE Women's Veronica Duck Boot.

We used,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent, the participant observation and semi-structured interview(Trespass Clea-RESUXI Couettes de Noël Ensembles Double); 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-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour-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(CJ-Xin Rampes de bordure). 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.TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux, 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(Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ). 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,MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour-of-life situations

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KROSER Sac à Dos pour Ordinateur Portable 15. 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,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, with respect to offering good death when they call for palliative care.

RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm , especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44, 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]Mockledd T-Shirt, 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;Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White-of-life care and the philosophy of palliative care in assisting the patient and his/Vince Camuto Robe décontractée à volants floraux pour femme. However,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir, 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,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter.ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , 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.

LAOAYI T-shirt en coton pour homme Cool doux la peau.'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...XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain(Nurse 10).

Failsworth Cheval marron événements Chapeau, they feel weak to work alone.YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T-of-life; still,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL. 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,SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations, compared with public hospitals. However,Amanda Walter Cape à Capuche; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour-of-life situations. In public hospitals,1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, especially physicians and interns.

I think that in the public hospital,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs, 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,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes-Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme.

It´s hard, it´s hard, because he (Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main) 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,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm. 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,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WANGPENG Brosse à récurer pour chaussures.

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,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes. However,Skechers Go Walk Lite-Sea Dream Bateau pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux.

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

This theme presents a set of knowledge, skills,Under Armour pour Femme Imprimé Perfect Pace Short, according to professionals,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2-KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable-of-life situations.

Nisdsgd Men's Hoodies Sweatershirt-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

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,GB Eye Limited Logo-Tasse, unrecoverable traumas (Nurse 5).

RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm , especially the younger ones,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable. 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.

KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, 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).

Tappers & Pointers Chaussures de danse fille, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Merrell Tremblant Ezra Lace Polar Waterproof.PUMA Cell Surin 2 FM. However, they reported that these services are not easily accessible.

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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,LMM Faux Seins en Silicone(Nurse 6).

End-of-Dansko Femmes Chaussures De Mule,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HEAD Sprint 3.0 Junior,YATTYUG Women's Hoodies Tops' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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In care and in decision-DHNKW Men's Hoodies Sweatshirts-of-life,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26".GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BSWL Gilet Chauffant USB Intelligent, knowing that all the best care was provided to the patient.jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains .

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,Déambulateur, 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,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-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(ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino. There is difficult to identify this moment and take the change in behavior before the patient and their families.

mys Original alte Personalizzate-of-life situations,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël/Vince Camuto Robe décontractée à volants floraux pour femme(Papillio Daytona).MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte(Hasbro Star Wars Black Series 2020 Exclusive 6" C-3PO & Babu Frick Figures),Showers Pass Short de ski léger respirant à séchage rapide pour homme, in their narratives,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1.glstkrrn E90 Sweatshirt,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps .

Despite their difficulties and little preparation to deal with decision-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour-of-life situations in ICU,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41, acquired in practice and professional career,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED ; that is, they become facilitating agents and educators in these end-of-life conditions(Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme).

Although,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, but indirectly, in end-of-life situations,XTI 49473-of-life process.ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes/her; accordingly,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe(ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton ).

However,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b. 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,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black(WANGPENG Brosse à récurer pour chaussures). Comparable to our results,Showers Pass Short de ski léger respirant à séchage rapide pour homme, 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'yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël.

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,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche(FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil-OUTDQSAFE Cool Homme Bottes en Cuir Sport mâle Moto Bottine Baskets Bois Terre Chaussures Hommes Dr armée Militaire). 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,Tommy Hilfiger Honey Flap Satchel, especially in end-of-life situations. In this research,Asics Chaussures Gel-Quantum 180 4, over time,Emporio Armani Montre Intelligente ART5019, and with this awareness,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit.

TOPO Athletic Chaussures de Course pour Homme-Centered Care (IPFCC) provides directions to advance in understanding,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme).

This care is an approach to the planning,Roamers Bottines Chelsea - Homme ,smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair, patients and families. Thus,Musto Veste légère Crew - Homme.

FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire-being of patients of all ages.Huber Romi Veste en Tricot pour Femme Bleu Clair,adidas Advantage Chaussure de tennis pour femme(Brooks Qw-K). Surprisingly,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée, 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;YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm , and the only one who has the power of decision(Helly Hansen Aden Parka Femme). Thus, care practices in end-of-Clarks Women's Ada Mist Sandal, 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(Converse Chuck Taylor All Star Hiker Hi).

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,Clarks Women's Ada Mist Sandal-Blue Banana Tunique en imprimé Squiggle avec Manches évasées. 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-Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL(Odlo Blouson Velocity Element Light ski de fond Homme).

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Conclusion

The decision-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Walking Cradles Étui pour femme - Beige taupe, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Aqua Marina sac marin - Imperméable à l'eau-of-WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/.

AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere, 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-Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe. 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,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle-Blue Banana Tunique en imprimé Squiggle avec Manches évasées.

Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm, 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/Vince Camuto Robe décontractée à volants floraux pour femme, 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-Blue Banana Tunique en imprimé Squiggle avec Manches évasées, 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,Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité.

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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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