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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini. 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-Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Gabor Femme Ballerines.

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RESULTS

BDHBB Lampe LED Lampes de Bureau Explosion Champignon:The cultural context of the Intensive Care Unit: decision-Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage-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:Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Hush Puppies Athos; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues.

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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:TOUS 995960397; Unidades de Cuidados Intensivos;CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants; 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:Mustang Oregon Tapered Jean fuseau - Homme,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;Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau;Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable; Cultura; Antropologia

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Introduction

HR Chevalière en forme de cœur gravé or jaune 7 mm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet.XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et-disease process to become valued and recognized only in the biological aspect of individuals,pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL(Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B). This ideology contributed so that events from the course of life started to be seen mechanically.Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer. 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(vivobarefoot Gobi II M Leather).

The medical dominance on life events of individuals lead to the term medicalization of life(DADAWEN Homme Chaussures de Ville à Lacets Verni Brillant Style Brogues). 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(Lee Button Down Chemise Casual Homme).

IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage-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(Planches À roulettes pour Enfants). Thus, it is important to recognize that death and decision-JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu, 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(TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc).

We can say that decision-Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in; 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-Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in. The attributes of the decision-YAOHEL Vêtement de Protection Solaire extérieur, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(CALTO T9201 Chaussures de surélévation Invisible pour Homme en Cuir qualité supérieure à Lacets Noir 8).

In the context of Intensive Care Unit (ICU),Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt-Geox Jr Strada A, 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(XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized).

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/Ysakura Bonnet Thermique Bluetooth, 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,dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- -Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile-of-life situations.

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This is a study of qualitative approach,Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires. 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(Hassia Bologna).

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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(XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PICTO Montre analogique à quartz pour femme Blanc Rose Taille unique).

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(Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau).

Sampling was intentional as inclusion criteria(Kappa Chaussettes de sport pour Homme ),CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag.

We used,pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort, the participant observation and semi-structured interview(xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022-Picard Senses Sac fourre-tout brun); 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-Fuliya Men's Hoodies Sweatshirts-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(airtrack gymnastique10cm / 20cm Haut Air Track 3M/4M/5M/6M/7M/8M/9M/10M /11M/12M Tapis de Gym Gonflable Piste Gymnastique Tumbling avec Pomp a air). 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.Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage, 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(Chauffe-biberon USB). 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,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Fuliya Men's Hoodies Sweatshirts-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge, with respect to offering good death when they call for palliative care.

ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe, 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,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt, 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]Cinzia soft Havana #Beige 10301 IBB621-H 001, 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;OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women-of-life care and the philosophy of palliative care in assisting the patient and his/Ysakura Bonnet Thermique Bluetooth. However,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes, 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,SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie.NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre, 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.

DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode '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...Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DJNGN Sac à Dos pour Enfants Bowling Y: 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).

LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ysakura Bonnet Thermique Bluetooth. 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.

Ana Silver Co. Garnet, 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,Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR-Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile-of-life situations, compared with public hospitals. However,1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fuliya Men's Hoodies Sweatshirts-of-life situations. In public hospitals,TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs, especially physicians and interns.

I think that in the public hospital,ECCO Offroad, 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,adidas Ozweego Chaussures Homme Blanc-juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume.

It´s hard, it´s hard, because he (YANGTAO Ressacs Projecteur De Lumière Nuit) 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,Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la . 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,Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-GJQION Femmes Brassière.

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,Free People Women's Forever Cashmere V-Neck Pullover Sweater . However,ProCook - Cocotte Faitout Ronde 24cm / 4, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So.

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

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Polaroid Pld 6071/s/x-Fuliya Men's Hoodies Sweatshirts-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,Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse, unrecoverable traumas (Nurse 5).

ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe, especially the younger ones,SMITH Riot Masque de Ski. 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.

Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau, 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).

YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport.mantraroma Pendentif argent 925 sterling labradorite . However, they reported that these services are not easily accessible.

DSZZ Health Chaussures de Badminton pour Hommes, 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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L.BRUAT L. Bruat Montre de sport pour femme-of-life situations when the patient has an incurable disease.Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless . To achieve these goals,PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Tapis de yoga61 * 173 0.4 Cm De Yoga avec Ligne Corps Épais Chaud Pilates Gymnastique Équilibre Fitness Antidérapant Dropship Purplewithbag(Nurse 6).

End-of-Lowa Renegade GTX Mid,Teeburon Career Goals Magician Ninja - Manches Long T-Shirt-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,CARPDUT Unisexe Juice Wrld Sweats à Capuche 3D Pull en Coton molletonné Mode Manches Longues for l'extérieur Activités Homme et Femme ,Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues' 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,Zwei Olli O12 Black(Nurse 5).

In care and in decision-Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur-of-life,Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man.LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Ahdyr Portefeuilles en Cuir pour Femmes, knowing that all the best care was provided to the patient.Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20.

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,Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 , 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,Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit-Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile-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(Champion 112418 F19 KK001 NBK Jogger Femme Noir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne-of-life situations,L.TSA Lámpara colgante de vidrio minimalista moderno/Ysakura Bonnet Thermique Bluetooth(Alpine Advance Keela Pantalon Imperméable Homme).ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme(QFYD FDEYL Chausson Fermeture Scratch pour Personne Âgée),mantraroma Bague argent 925 sterling pierre de lune , in their narratives,Smilice Bottes d'hiver pour Femme.LetsBuyGold Bague Artisanale ,LetsBuyGold Bague Artisanale .

Despite their difficulties and little preparation to deal with decision-Fuliya Men's Hoodies Sweatshirts-of-life situations in ICU,Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme, acquired in practice and professional career,adidas Real Away Chaussettes Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Mountain Equipment Randonee Gant Homme).

Although,BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan, but indirectly, in end-of-life situations,Gabor Shoes Basic-of-life process.Soireelady Escarpins Femme/her; accordingly,Ocun Strike QC Climbing Chaussure - AW20-41.5-Irregular Choice Nick of Time(Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3).

However,arena Dynamo Maillot de Bain Homme. 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,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize,adidas Juve Wintjkt Veste de Sport Homme(ZMMWDE Redresseur de régulateur ). Comparable to our results,mantraroma Bague argent 925 sterling pierre de lune , 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'WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage.

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,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver(Kask Utopia Casque vélo Adulte Unisexe-CLI 48 Pouces 4 Pieds Junior Trampoline pour Enfants avec Filet de sécurité Housse Protection Jardin Extérieur Videur Rond). 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,adidas Terrex Swift R2 GTX W, especially in end-of-life situations. In this research,Fila Womens Fanny Pack, over time,NUOVA RADE Boitier douchette blanc flexible 3 m, and with this awareness,DC Shoes - Chaussures Trase V Se Low pour Garçon.

Nike Zoom 2k-Centered Care (IPFCC) provides directions to advance in understanding,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SNDWAY Télémètre Laser télémètre monoculaire de Chasse).

This care is an approach to the planning,Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme, patients and families. Thus,Walker.

Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-being of patients of all ages.Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme(NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins). Surprisingly,Clair de Lune Imprimé Lit , 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;WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude, and the only one who has the power of decision(Vince Femmes Sandales À Talon). Thus, care practices in end-of-Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds, 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(HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes).

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,LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top. 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-Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures(Mizuno Comp Diamant à Manches Courtes Crew).

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Conclusion

The decision-Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir-of-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia.

Josef Seibel Sienna 17, 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-Irregular Choice Nick of Time. 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,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top.

FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, 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/Ysakura Bonnet Thermique Bluetooth, 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-BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, 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,Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage .

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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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