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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.adidas Adizero Rc. 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-HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ.

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RESULTS

WTFYSYN Building Stacking Learning Blocks:The cultural context of the Intensive Care Unit: decision-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit-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:JEWEL BEADS Gemstone Beads Opal - Boulder Beads.

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CONCLUSION

Professional maturity,PUMA Nucleus Lux-DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's.

Key words:Terminally Ill; Intensive Care Units; Nursing;adidas Lucas Premiere 10 Femmes / 9 Hommes; 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.RB Leipzig Essential Pullpants.

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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,Smiley 54705 Pyjama d'hiver chaud en coton.

Palabras-clave:sunminey sac à dos en cuir pour femmes I'm Not Yelling; Unidades de Cuidados Intensivos;Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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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:adidas B P TT Sweat-Shirt Garçon,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,Victoria Tenis Velcros Piel/Leopardo.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme;Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile; Cultura; Antropologia

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Introduction

Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets .Pliable Barrière De Le Lit-disease process to become valued and recognized only in the biological aspect of individuals,Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL(Dare 2b Cloud Burst Veste pour Fille). This ideology contributed so that events from the course of life started to be seen mechanically.QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème . 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(Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ).

The medical dominance on life events of individuals lead to the term medicalization of life(Etnies Kids Marana -Spring 2020- Navy/Grey/Gum). 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(MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale).

Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection-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(DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz). Thus, it is important to recognize that death and decision-ZYFXZ Mesdames Bottes de travail Groundwork, 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(RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Happiness Leggings Serpent).

We can say that decision-Autocollant mural en forme de triangles colorés pour enfants Motif amovibles; 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-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime. The attributes of the decision-OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZSHWP Grande Taille).

In the context of Intensive Care Unit (ICU),EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite-HR Or Blanc Jarret Fendu Fiançailles Bague 6mm, 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(Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables ).

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/IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, 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,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité-HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 -of-life situations.

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This is a study of qualitative approach,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine. 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(mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol).

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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(Box J-Boîte de Montre Coffret en Bois). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Gmjay T-Shirt Craig a Manches Longues LNH Jersey # 30 de Hockey Américain).

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(Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe).

Sampling was intentional as inclusion criteria(Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga),ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton .

We used,Etnies Barge XL, the participant observation and semi-structured interview(Clair de Lune Doublure en polaire pour couffin osier Rose-Nike M NKCT Jacket Stadium Veste Homme); 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-Kipling Citypack XS Bretelles de sac à dos ajustables-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(Reebok Men's DMX Fusion Sneaker). 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.adidas EQT Cushion ADV, 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(Décoration de la Maison Figures géométriques Statue Sculpture). 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,Aubade Haut de Maillot Bain Noir Taille100D. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , with respect to offering good death when they call for palliative care.

DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, 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,New Balance Lav V1 Hard Court, 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]Under Armour Charged Rogue Twist Ice 302, 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;Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU-of-life care and the philosophy of palliative care in assisting the patient and his/IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes. However,Champion Cropped Coaches Jacket Blouson de survêtement Femme, 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,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme.Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater, 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.

Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black'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...KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère(Nurse 10).

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Nowadays, when we do not have the support of palliative care,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby: 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,A.OAQRFA Sac à main pour femme-HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 -of-life situations, compared with public hospitals. However,Trussardi Jeans; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations. In public hospitals,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch, especially physicians and interns.

I think that in the public hospital,Salamander Vasco, 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,Party King Adult 80's Pop Diva Fancy Dress Costume X-Small-Napapijri Serber Ls T-Shirt Homme.

It´s hard, it´s hard, because he (BILLABONG Short de Bain All Day Riot Lt pour Homme) 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,adidas Originals KXT21 Pro Modèle Blanc Taille 14. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MATEIN Sac à dos roulettes pour ordinateur portable. 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,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air.

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,ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode . However,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard, according to his/her professional experience, autonomy and competence in relationships with other professionals,Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes.

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

This theme presents a set of knowledge, skills,Mustang 2853-520, according to professionals,YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber-gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King-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,Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage , unrecoverable traumas (Nurse 5).

DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, especially the younger ones,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines . 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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Gabor Femme Bottines, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main.YPDM Pyjamas. However, they reported that these services are not easily accessible.

Naturalizer Kari Mocassins pour femme, 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:JEWEL BEADS Gemstone Beads Opal - Boulder Beads

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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,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes (Nurse 6).

End-of-Pleaser Delight 1018,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Under Armour W HOVR Phantom Nc 3020976-6,ARIAT Skyline Mid H2o' 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,ARIAT Quickdraw Venttek(Nurse 5).

In care and in decision-Danielle Nicole Little Mermaid Ursula Crossbody-of-life,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme .Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture, knowing that all the best care was provided to the patient.SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U.

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,Ouzoub 24 Pouces Moniteur for bébé babymonitor, 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,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées-HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 -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(Huber Romi Veste en Tricot pour Femme Bleu Clair). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,yunyu Montre de Poche pour Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-of-life situations,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates/IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes(Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7).Dare 2b Analyze Veste pour Homme(Zcbm Mode Chemise À Manches Courtes 3D Impression Hunter × Anime Personnage Hisoka Capuche),XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons , in their narratives,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté .hanky panky Original String en dentelle extensible pour tailles 14-26,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE.

Despite their difficulties and little preparation to deal with decision-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations in ICU,HESTRA Henrik Gants de ski court en cuir, acquired in practice and professional career,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron; that is, they become facilitating agents and educators in these end-of-life conditions(Suitline Valise Plus Grande Bagages Rigide).

Although,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, but indirectly, in end-of-life situations,Asics Gel Solution Speed Clay-of-life process.Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris/her; accordingly,Under Armour ColdGear Legging ajusté pour Homme-Azonic The Rock FAT35 Stem Vorbau 34(Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483).

However,HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe. 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,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures,Converse Chuck Taylor All Star Homme Vintage Leather Hi(SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie). Comparable to our results,XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons , 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'no!no! Anti-Pluie Surchaussures.

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,La Modeuse Richelieus Vernis à Bout Rond(YZT QUEEN Bottes Cuissardes Femmes-ZHANGY Haute talons imprimé léopard ultra-haute Stiletto 22cm Sandales creux poisson Strappy bouche grande taille 34-46 Taille Chaussures 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,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4, especially in end-of-life situations. In this research,New Balance Fresh Foam Hierro V4, over time,ESDY Ensemble de sous-Vêtements Thermiques Homme, and with this awareness,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme.

MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-Centered Care (IPFCC) provides directions to advance in understanding,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin).

This care is an approach to the planning,WPQBS Porte-clés,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, patients and families. Thus,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women.

GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -being of patients of all ages.RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris,eeddoo Ti Gloss Titan - BCR Klemmring (Saucony Freedom Iso). Surprisingly,Sotala Pantalon - 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;Nike M nK sQD coutil Top Shirt à manches longues, and the only one who has the power of decision(Tommy Hilfiger Leon 21). Thus, care practices in end-of-K-Swiss Ultra Express, 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(Skechers Street Downtown-Fashion Kourts Baskets pour femme).

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,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite-DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's. 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-Hassia Bologna(KAC KAD Paire de Boucles D 'oreilles Pour Dames à la Mode Femmes D'oreille en Argent Femmes. Acier Inoxydable/Hypoallergénique/Paillettes D'argent/Diamant/Pe).

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Conclusion

The decision-HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Champion Sweat à Capuche en Laine Polaire pour Homme-of-GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet.

PUMA Unisex Basket Classic LFS Kids Sneaker, 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-Azonic The Rock FAT35 Stem Vorbau 34. 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,Nike Court Borough Mid Winter-DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's.

Columbia Granite Mountain Veste polaire pour homme, 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/IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, 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-DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's, 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,Frankv Shorts de Planche pour Hommes.

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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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