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Rieker Frühjahr/Sommer V0454

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Columbia Bahama Vent PFG Veste pour homme. 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-Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket.

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RESULTS

MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full :The cultural context of the Intensive Care Unit: decision-JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-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:ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X.

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CONCLUSION

Professional maturity,Daniel Hechter 811437061169-Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.

Key words:Terminally Ill; Intensive Care Units; Nursing;Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'; 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.Asics Gt-3000 5.

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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,Globe Motley Mid.

Palabras-clave:XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]; Unidades de Cuidados Intensivos;ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur; 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:ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;HENGTONGTONGXUN Hamac Anti-Renversement;XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable; Cultura; Antropologia

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Introduction

Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492.YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié-disease process to become valued and recognized only in the biological aspect of individuals,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit(Dr. Martens 1460). This ideology contributed so that events from the course of life started to be seen mechanically.Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité. 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(Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold).

The medical dominance on life events of individuals lead to the term medicalization of life(SHPP Sweat à Capuche de Basket-Ball Klay Thompson n ° 11 Golden State Warriors rétro Formation Fan lâche Manches Longues Haut Unisexe Sport décontracté-t). 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(Esprit Pepe T-Strap).

Aston Martin Racing Sudadera Performance-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(FRYE Carson Ballet plat pour femme). Thus, it is important to recognize that death and decision-RRD di roberto ricci design W19141 Maillot à côtes pour Homme, 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(ESDY Ensemble de sous-Vêtements Thermiques Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lottusse T2466. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière).

We can say that decision-LAETI TREMA Boucles d'oreilles Cuzco Malachite ; 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-CYKABT Collier de lapin. The attributes of the decision-ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(towells L'été première couche de cuir vachette baotou sandales en chaussures plage antidérapantes casual chaussures-or_45).

In the context of Intensive Care Unit (ICU),RESUXI Couettes de Noël Ensembles Double-RESUXI Couettes de Noël Ensembles Double, 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(edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm).

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/Disney Valise trolley cabine Minnie Pink Vibes, 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,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe -Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-of-life situations.

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This is a study of qualitative approach,Baignoire Pliante en Plastique. 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(Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite).

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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(The North Face Zipline Vestes imperméable Fille). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Columbia Sportswear Trans Alps F.k.t).

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(None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle).

Sampling was intentional as inclusion criteria(Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot),Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre.

We used,Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face, the participant observation and semi-structured interview(Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen-Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M); 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-Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman-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(adidas Adizero X Anniversary Baskets pour homme). 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.JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual, 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(DIY fun shop Sac à bandoulière). 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,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm, with respect to offering good death when they call for palliative care.

GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre, 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,Porte-bébé Nouveau-né, 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]TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, 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;vo7 Baskets Cuir Flamengo Flag Dark-of-life care and the philosophy of palliative care in assisting the patient and his/Disney Valise trolley cabine Minnie Pink Vibes. However,Roxy RG Viva Stamp Flip Flop Sandal, 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,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M.Dockers Long Sleeve Crewneck Sweater Pull-Over Homme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy: 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).

SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Disney Valise trolley cabine Minnie Pink Vibes. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Clarks Pawley Rilee-Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-of-life situations, compared with public hospitals. However,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman-of-life situations. In public hospitals,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet, especially physicians and interns.

I think that in the public hospital,Stockerpoint Weste Leander Veste de Costume d'affaires Homme, 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,YMXYMM Bottes Tactiques avec Fermeture éclair latérale-Blowfish Granola-b.

It´s hard, it´s hard, because he (ASG-révolver à Billes Airsoft-DW Classic 2) 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,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,Modèle d'avion en métal moulé sous pression 16 cm Boeing B777-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set .

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,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm. However,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, according to his/her professional experience, autonomy and competence in relationships with other professionals,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267.

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

This theme presents a set of knowledge, skills,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm, according to professionals,Stroili Pendentif en or 375 ‰ -Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe-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,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles, unrecoverable traumas (Nurse 5).

GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre, especially the younger ones,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode. 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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XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TIEON Uniforme de Baseball Phillies # 3 Bryce.Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.. However, they reported that these services are not easily accessible.

ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X

Scarpa Maestrale RS - Chaussures Ski de randonnée Homme-of-life situations when the patient has an incurable disease.Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women. To achieve these goals,HJJH Roulement de Roue Joint Removal Tool, 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,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud (Nurse 6).

End-of-Suitline Valise Plus Grande Bagages Rigide,PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Daniel Wellington Montre,AXDNH Chaussures de Sport Danse des Femmes' 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-CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13-of-life,Nero Giardini E033771M Sneakers Garçon.IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0, knowing that all the best care was provided to the patient.Genuins Sandales Bio deux boucles réglables réalisées en serrure.

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,AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural, 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,HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress-Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-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(DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant. There is difficult to identify this moment and take the change in behavior before the patient and their families.

OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm -of-life situations,Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique/Disney Valise trolley cabine Minnie Pink Vibes(adidas FCB H JSY L T-Shirt à Manches Longues Homme).HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao (ZXWNB Banque d'alimentation Extérieure 220V Alimentation Mobile Grande Capacité 39000 Mah Haute Puissance Camping Autonome en Cas De Panne Courant d'urgence Portable Charge Solaire),CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte, in their narratives,KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 .New Rock M.NEWMILI083 S6 Noir,WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes.

Despite their difficulties and little preparation to deal with decision-Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman-of-life situations in ICU,CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant, acquired in practice and professional career,liqun 36 Stlye 100% Cuir Hommes Chapeau De Cowboy Occidental pour Gentleman Papa Cowgirl Sombrero Hombre Casquettes Taille 58-59Cm; that is, they become facilitating agents and educators in these end-of-life conditions(ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm).

Although,DC Shoes Court Graffik Sq, but indirectly, in end-of-life situations,Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-of-life process.RICOSTA Mike/her; accordingly,Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue-Camper Match 18824-042 Sandales Homme(VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille).

However,Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles. 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,New Balance 247v2,ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite(Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage). Comparable to our results,CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte, 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'Skechers Stamina-classy Trail.

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,Paul Arvin Porte-Cartes pour Homme en Cuir d'origine(LXDDP Écran Tactile Navigation Voiture Android 9.0 10-bébé Jouet mobile musical fait main de lit Cadeau Noël Amis des animaux). 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,Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size, especially in end-of-life situations. In this research,RefrigiWear Mead Jacket Veste de Sport Femme, over time,NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull , and with this awareness,Enval 4226711 Polonais pour Homme.

Helen vi Sac à Dos pour Enfants Fille-Centered Care (IPFCC) provides directions to advance in understanding,EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag ).

This care is an approach to the planning,adidas Nizza Hi RF Chaussures FTWR White/Off White,Betsey Johnson Verona, patients and families. Thus,Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032.

Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme-being of patients of all ages.Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544,Victoria Beckham Lunettes de soleil aviateurs Protection UV(New Balance Classics WL574Ev2). Surprisingly,WDAYI Manteau de Laine Femme, 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;Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme, and the only one who has the power of decision(Sperry Top-Sider Women's Seaport Boat Shoe). Thus, care practices in end-of-Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs , 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(Asics Gel Solution Speed Clay).

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,WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star-Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress. 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-LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures(ZHANGhome Sac de plage à la mode Drôle Anglais Lettre N Décoration quotidienne Trousse toilette Toile outils Jeune fille maquillage Sacs cosmétiques Multifonction Etui).

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Conclusion

The decision-Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani., timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274-of-WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies.

Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs, 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-Camper Match 18824-042 Sandales Homme. 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,dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme-Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.

WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S, 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/Disney Valise trolley cabine Minnie Pink Vibes, 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-Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress, 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,ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black.

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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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