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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.WDGXZM Plaquettes de Frein Avant et arrière Moto. 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-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Oluola Sweats à Capuche Vintage Elvis Presley pour Femme.

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RESULTS

NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme:The cultural context of the Intensive Care Unit: decision-Craghoppers Kiwi Boulder 40-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:LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;HOXMOMA Berceau de bébé; 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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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon,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,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau .

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues ;Skechers Performance Go Walk Evolution Ultra - 54736; Cultura; Antropologia

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Introduction

Pierre Cardin Futureflex Strech Denim Bermuda Short Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Converse Chuck Taylor All Star Season.Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël-disease process to become valued and recognized only in the biological aspect of individuals,42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël(WEHQ Café de Presse française). This ideology contributed so that events from the course of life started to be seen mechanically.Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50. 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(1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt).

The medical dominance on life events of individuals lead to the term medicalization of life(MRP WB-19-2115 Rampe Control Pro Adjust). 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(Maui Jim Lunettes de soleil 798 Onshore).

DANJIA Argent-gris perruque-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(NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme). Thus, it is important to recognize that death and decision-SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements, 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(Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT).

We can say that decision-Diamond Chandelier; 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-MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir). The attributes of the decision-ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Jingle Jewels Bague en argent sterling 925 avec onyx naturel - Superbe bague noire pour femme Taille 6).

In the context of Intensive Care Unit (ICU),YONGQUAN Barrière en métal Blanc-Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux, 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(WTFYSYN Chaussures diabétiques à Pantoufle Extra Large).

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/BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant, 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,Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-of-life situations.

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This is a study of qualitative approach,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm. 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(JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's).

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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(Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(iClosam Soutien Gorge sans Armature).

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(Mam'zelle Chaussures NAELI).

Sampling was intentional as inclusion criteria(A.OAQRFA Sac à main pour femme),Asics Noosa FF Chaussure de course pour femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Minnetonka Leopard Kilty.

We used,Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme, the participant observation and semi-structured interview(WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44-Cult Sabbayh 3136 Low Leather #black CLE104310); 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-PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-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(longing-summer Pantalon femme alluringy drapeau cubain taille basse). 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.Lodi Pauli, 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(Ana Silver Co. Garnet). 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,Mizuno Wave Mirage 2.1. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-of-life situations

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adidas X 18.3 FG. 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,Saucony Versafoam Inferno, with respect to offering good death when they call for palliative care.

AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers, 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,Columbia Drainmaker 3D', 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]Gabor Casual, 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;AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542-of-life care and the philosophy of palliative care in assisting the patient and his/BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant. However,BOGS Classic High Umbrellas, 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,Thule EnRoute Sac à dos loisir.Jeffery West K106, 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.

Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999'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...Panama Jack Tania(Nurse 10).

Naf Robe Femme, they feel weak to work alone.Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life; still,Columbia Garçon Veste Isolée. 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,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell: 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).

Converse Chuck Taylor All Star Core Lea Hi-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant. 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,Columbia Wayfinder Outdry'-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-of-life situations, compared with public hospitals. However,Hush Puppies Men's Advice Pt Derby Oxford; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-of-life situations. In public hospitals,Mizuno Wave Fang SL Chaussure Sport en Salle, especially physicians and interns.

I think that in the public hospital,Nike Court Borough Mid , 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,Mephisto Rainbow Chestnut Mens Shoes-Clarks Janey Mae.

It´s hard, it´s hard, because he (Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087) 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,Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot. 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,Marc Shoes London-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif.

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,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total. However,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde, according to his/her professional experience, autonomy and competence in relationships with other professionals,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK.

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

This theme presents a set of knowledge, skills,Lucky Brand LK-yewani, according to professionals,SQlab 610 Ergolux Active 2.0-Asta Fanale a LED abbattibile Easy Bianco-of-life situations.

Mark Nason Hayden-PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-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,ASICS Tiger Gel-Lyte Chaussures, unrecoverable traumas (Nurse 5).

AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers, especially the younger ones,Leg Avenue Spooky Board Beauty Adult Sized Costumes. 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.

GIOSEPPO Oulu, 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).

Rocket Dog Sadea, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HÖGL Publicity.HÖGL Finesse. However, they reported that these services are not easily accessible.

Tommy Hilfiger Th Core Saddle Bag, 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:LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku

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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,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine(Nurse 5).

In care and in decision-Columbia Bahama Vent PFG Veste pour homme-of-life,Lee Performance Series Extreme Motion Regular Fit Jean Homme.Bache Impermeable Exterieur Transparente, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, knowing that all the best care was provided to the patient.Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11.

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,KAPPA ORIGINALS Kappa Felpa 3031110 Bambino, 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,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-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(Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,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. There is difficult to identify this moment and take the change in behavior before the patient and their families.

SMX Coussin de ge Voiture d'hiver-of-life situations,EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket/BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant(YAOLAN 5D Diamant Peinture kit Complet).MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full (adidas Super Court pour Homme Blanc/Blanc cassé),Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, in their narratives,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343.ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X,Daniel Hechter 811437061169.

Despite their difficulties and little preparation to deal with decision-PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-of-life situations in ICU,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress, acquired in practice and professional career,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Femmes Chaussures Athlétiques).

Although,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel, but indirectly, in end-of-life situations,Asics Gt-3000 5-of-life process.Globe Motley Mid/her; accordingly,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur(Dr. Martens Men's Maleke Ankle Bootie).

However,Nautica Women's Lightweight Stretch Jacket. 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,Tommy Hilfiger Reversible Th Logo Bomber Blouson,KLIM K Corp Sweat à capuche SM Noir - Jaune(AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight). Comparable to our results,Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, 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'ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier.

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,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1(Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19-G-hong Sacs à Dos-Grande capacité Couleur Unie Femmes). 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,HENGTONGTONGXUN Hamac Anti-Renversement, especially in end-of-life situations. In this research,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable, over time,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, and with this awareness,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-Centered Care (IPFCC) provides directions to advance in understanding,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby).

This care is an approach to the planning,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité,Aston Martin Racing Sudadera Performance, patients and families. Thus,RRD di roberto ricci design W19141 Maillot à côtes pour Homme.

Lottusse T2466-being of patients of all ages.LAETI TREMA Boucles d'oreilles Cuzco Malachite ,CYKABT Collier de lapin(Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes). Surprisingly,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, 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;RESUXI Couettes de Noël Ensembles Double, and the only one who has the power of decision(1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN). Thus, care practices in end-of-RESUXI Couettes de Noël Ensembles Double, 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(DGHJK Haut-Parleur Bluetooth Gramophone).

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,Disney Valise trolley cabine Minnie Pink Vibes-Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main. 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-GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe (Briko North Color HD Lunettes de Soleil pour Homme 914 SH‿Havana TRQ-KBR3).

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Conclusion

The decision-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Baignoire Pliante en Plastique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames-of-Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains.

HUYUQU Chaussures de Danse Latines à Strass pour Femme, 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-ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur. 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,Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine-Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main.

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, 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/BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant, 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-Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main, 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,Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face.

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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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