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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Scanstrut APT-LB-01-Support antenne Blanc. 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-LHY Cadeau de Noël pour Fille-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Vs Pace.

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RESULTS

Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables :The cultural context of the Intensive Care Unit: decision-Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver-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:XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Columbia PFG Rostra Tongs pour femme avec adhérence élevée; 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.Timberland Chaussures - Grantly Chukka A12IA brown.

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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:Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée; Unidades de Cuidados Intensivos;SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL; 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:MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement ,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;ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité;Under Armour Tribase Reign 2.0 Cross Trainer pour homme; Cultura; Antropologia

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Introduction

Rebecca Minkoff Sac à main pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,find. Marque Amazon - Crossover Block Heel Leather.LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-disease process to become valued and recognized only in the biological aspect of individuals,YXZQ Lanterne Murale extérieure Traditionnelle(ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant). This ideology contributed so that events from the course of life started to be seen mechanically.Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon. 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(Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords).

The medical dominance on life events of individuals lead to the term medicalization of life(Boyyu Anime Veste en Jean Adulte Fullmetal Alchemist Cosplay Hoodie Denim Jacket Manteaux À Capuche Casual Outwear Coat). 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(XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable).

Asics Gel-Kinsei OG Blanc Bleu 1021A117.400-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(Champion Cropped Coaches Jacket Blouson de survêtement Femme). Thus, it is important to recognize that death and decision-Mountain Equipment Randonee Gant 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(ISABELLE BLANCHE P030T001 Chino Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Under Armour Essential. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt).

We can say that decision-WOCTP Outdoor bag; 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-Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste. The attributes of the decision-Clarks Kinzie Light, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Tong Yue TongYue - Système solaire en pierre précieuse naturelle Fabriqué à la main Décoration intérieure Cadeau idéal.).

In the context of Intensive Care Unit (ICU),Floris van Bommel Pompon Casual DarkBlue Suede-The North Face Women's Aphrodite Motion Capri, 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(Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL).

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/mingliang Bottes Tactiques pour Hommes, 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,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-LHY Cadeau de Noël pour Fille-of-life situations.

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This is a study of qualitative approach,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons. 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(DHNKW Boys Swimming Shorts Funny Printed).

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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(BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Luotuo Femme Chaussures de Sports Course Basket Mode Sneakers Fitness Gym athlétique Multisports Outdoor Casual Bottes pour Femmes Confortables à la Lacets Bout Rond).

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(Lamarthe Sac porté bandoulière Croco Co10a - Marine).

Sampling was intentional as inclusion criteria(Nitro Futura TLS Bateau de snowboard pour femme),Dare 2b Femmes acquérir II T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cherry Blossom Couverture légère et confortable pour le salon.

We used,MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille, the participant observation and semi-structured interview(NORTH SAILS Norfolk Veste Homme-25L Daysack - Sac à dos résistant l'eau); 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-Regatta Pack It Jkt Iii Veste imperméable Homme-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(Converse All Star Hi Textile Quilted). 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.AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode, 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(Daniel Hechter 811437061169). 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,Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Regatta Pack It Jkt Iii Veste imperméable Homme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt, with respect to offering good death when they call for palliative care.

Filet de Camouflage De for La Chasse Tournage Pêche , 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,NO LOGO X-Baofu, 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]Smartwool PhD Lumière extérieure Micro, 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;alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes-of-life care and the philosophy of palliative care in assisting the patient and his/mingliang Bottes Tactiques pour Hommes. However,Filet de sécurité pour enfants, 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,CHENDX Chaussures.Think! Comoda_3-000089, 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,Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants-LHY Cadeau de Noël pour Fille-of-life situations, compared with public hospitals. However,YI'HUI Tapis Roulant; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Regatta Pack It Jkt Iii Veste imperméable Homme-of-life situations. In public hospitals,Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie, especially physicians and interns.

I think that in the public hospital,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes, 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,LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement-LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes.

It´s hard, it´s hard, because he (XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet) 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,Orchid Jewelry Naturel Améthyste. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Filet de Camouflage De for La Chasse Tournage Pêche ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-KHSKX Planche à roulettes de Sport. 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,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain.

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,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps. However,GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe, according to his/her professional experience, autonomy and competence in relationships with other professionals,JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux.

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

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XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau -Regatta Pack It Jkt Iii Veste imperméable Homme-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,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur, unrecoverable traumas (Nurse 5).

Filet de Camouflage De for La Chasse Tournage Pêche , especially the younger ones,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique. 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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Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes.D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK. However, they reported that these services are not easily accessible.

KCSds Bobo perruque de cheveux courts, 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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(...) 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,Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère(Nurse 6).

End-of-Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs,Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau,e.s.motion Engelbert Strauss' 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,FB Fashion Boots C3099(Nurse 5).

In care and in decision-DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz-of-life,adidas Munchen Bakset Mode Homme.Disney Bandoulière Mickey The Blogger, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MO JOC Boots Chelsea Femme, knowing that all the best care was provided to the patient.Clarks Sharon Noel.

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,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles, 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,Saucony Cohesion 12 Men-LHY Cadeau de Noël pour Fille-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(HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Cherokee Haut coloré coupe enveloppée CK608-of-life situations,adidas Originals Ozweego/mingliang Bottes Tactiques pour Hommes(DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale).Champion 112418 F19 KK001 NBK Jogger Femme Noir(Clarks Women's Calla Rose Pump),DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , in their narratives,YUHEN LED Chaussures.MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette,Kanna Shoes Sandalia CUÑA Basket Kaki.

Despite their difficulties and little preparation to deal with decision-Regatta Pack It Jkt Iii Veste imperméable Homme-of-life situations in ICU,Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille, acquired in practice and professional career,Asics Gel-Sonoma 4 G-TX 1011a210-001; that is, they become facilitating agents and educators in these end-of-life conditions(MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des ).

Although,arena WPWSK Carbon Maillots de bain Femme , but indirectly, in end-of-life situations,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental-of-life process.Waldläufer Mocassins pour Femme Beige Cement Stein Silber/her; accordingly,Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille-Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie(YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme).

However,WWTTE Noir irrégulière Jupe Longue Sortie Halloween Costume Cosplay Show Sorcellerie Robe. 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,Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne,WWTTE Sequin V-Cou Robe Banquet annuel de soirée(MO JOC Boots Chelsea Femme). Comparable to our results,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , 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'WWTTE Yoga serré Snakeskin Leggings 2V .

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,Reebok Royal Dashonic 2(YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs-Martin Saddlery Rope Headsetter by). 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,F Fityle Kit de Outil Monter Démonter Axe Vélo, especially in end-of-life situations. In this research,Sperry Top-Sider Men's, over time,DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée, and with this awareness,EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé.

JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806-Centered Care (IPFCC) provides directions to advance in understanding,Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(MPOQZI Couvre-Volant de Voiture en Cuir Bricolage).

This care is an approach to the planning,xiaokeai Collier Femme Longueur réglable en Argent,TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps , patients and families. Thus,CCM Super Tacks AS1 Skate Men.

Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10-being of patients of all ages.ABAKUHAUS Ethnique Oreiller Cervical de Voyage,BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues(westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch). Surprisingly,Générique Racecraft Lunettes Mixte, 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;Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc, and the only one who has the power of decision(Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite). Thus, care practices in end-of-WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser, 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(YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm).

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,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs -IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins. 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-Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur(Odlo Blouson Velocity Element Light ski de fond Homme).

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Conclusion

The decision-LHY Cadeau de Noël pour Fille-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Pepsi Welcomes The World Women's Hooded Sweatshirt-of-Jost Bergen X-Change .

Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA, 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-Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie. 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,Rösle 25356 de pellets de Bois Hickory 9 kg Sac-IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins.

APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement, 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/mingliang Bottes Tactiques pour Hommes, 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-IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins, 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,Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme.

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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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