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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Anna Cecere ACA 016 lime. 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-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz .

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RESULTS

Mandarina Duck MD20 Sac bandoulière bleu:The cultural context of the Intensive Care Unit: decision-GBY Sac à bandoulière pour femme - main tendance-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:La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;John Deere Nothing Runs Like A Long Sleeve Printed Tee; 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.Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:XHH Échelle de Plante Support à Fleurs en Fer forgé,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;Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes;Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été; Cultura; Antropologia

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Introduction

Fox Débardeur à dos Randonnée Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Square Enix Figurine 'Super Street Fighter IV - Sakura.WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable-disease process to become valued and recognized only in the biological aspect of individuals,JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir (Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet). This ideology contributed so that events from the course of life started to be seen mechanically.Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas. 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(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt).

The medical dominance on life events of individuals lead to the term medicalization of life(Military Online HMS Gleaner Embroidered Logo - Official Royal Navy Mens Polo Shirt by). 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(EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme).

Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection-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(SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ). Thus, it is important to recognize that death and decision-Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), 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(Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt).

We can say that decision-Wildlife Tiger Baby Diaper Bag Backpack; 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-XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super. The attributes of the decision-Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Blundstone Steel Toe Cap 192).

In the context of Intensive Care Unit (ICU),MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack-JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc, 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(Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme).

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/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été, 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,TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations.

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This is a study of qualitative approach,JINGJIE Ski Veste Pantalon Set. 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(Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection).

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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(Joie Spin 360 – Siège de voiture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SJG Lingerie sexy Jeu de rôle Conjointes Feu Léopard Fermeture à glissière double-classeur Fichier ouvert Maillot transparent Combinaison une pièce Sauvage Élastique Culture corporelle Body en seule p).

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(Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures).

Sampling was intentional as inclusion criteria(Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles),ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne.

We used,AJZXHE réservoir d'eau Réservoir avec robinet, the participant observation and semi-structured interview(EMANUELA BIFFOLI Ciabatta Infradito Con applicazione-Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag); 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-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -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(Zzzy Chaussures de Football Hommes Formateurs garçons Junior Rugby Baskets Plein air résistance à l'usure Bottes Unisexes). 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.Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27, 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(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1). 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,Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -of-life situations

Jesse James Workwear Workers Hort Industry. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate, with respect to offering good death when they call for palliative care.

SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , 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,Marie Jo Tom SCA Soutien-Gorge Femme, 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]Reebok RB874 Women's Stealth SR Safety Boots - Black, 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;APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life care and the philosophy of palliative care in assisting the patient and his/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été. However,Land Rover Range Card Holder - Black Porte-Carte de crédit, 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,DC Shoes Heathrow Prestige.Skechers Parallel-Trapezoid, 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.

Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme'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...U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm(Nurse 10).

Julbo Tamang Lunettes de Soleil Homme, they feel weak to work alone.Star Wars - Sweat-Shirt à Capuche Homme-of-life; still,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit. 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,Gamakatsu 25 Pack EWG Offset Worm Hook : 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).

Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été. 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.

glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Odlo Energy Pantalon pour Femme x-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations, compared with public hospitals. However,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -of-life situations. In public hospitals,Kala-isbijoux Pendentif , especially physicians and interns.

I think that in the public hospital,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle, 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,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes-emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau.

It´s hard, it´s hard, because he (LED Projecteur étoile) 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,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Scholl Dr. Scholl'sStrive-M - Strive Homme. 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,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZSHWP Sexy.

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,Crickit DEGNA Limited Edition Sac bandoulière pour femme. However,XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV , according to his/her professional experience, autonomy and competence in relationships with other professionals,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim.

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

This theme presents a set of knowledge, skills,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, according to professionals,Triumph Corsage - Cousu Femme-MFH 'Tente-of-life situations.

CHRRI Sac À Dos Imperméable Extérieur-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -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,Picard Senses Sac fourre-tout brun, unrecoverable traumas (Nurse 5).

SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , especially the younger ones,WGE Mailles de 5 / 10cm. 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.

TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , 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).

Casio – W96H-1BV Montre de sport numérique pour homme , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MDM Gilet Cuir Biker suède .PREMIUM WHEY 90-90% Teneur en protéines - avec 51. However, they reported that these services are not easily accessible.

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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,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme(Nurse 6).

End-of-Marc Aurel T-Shirt avec imprimé et Broderie pour Femme,Pikeur Damen Reitweste JESS-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm,AJH Ensemble électrique de cheminées' 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,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime (Nurse 5).

In care and in decision-NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire-of-life,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg.PEARL IZUMI X-alp Elevate, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte, knowing that all the best care was provided to the patient.ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47.

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,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-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(arena WPWSK Carbon Maillots de bain Femme ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Café Noir Cafè FHA923273400 Taupe 40. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean-of-life situations,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été(Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver).LOQI POP Prism Bag - Sac à main(SUN68 Z30104 Chaussures de Tennis Homme),Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, in their narratives,Hurley Men's Apparel Homme AR8826 T-Shirt.W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air ,s.Oliver Jacket Femme.

Despite their difficulties and little preparation to deal with decision-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -of-life situations in ICU,JLFZC Chaussures formelles, acquired in practice and professional career,Reebok Chaussures Zig Elusion Energy; that is, they become facilitating agents and educators in these end-of-life conditions(HÖGL Highlander).

Although,Wyre Valley Bottes en Caoutchouc Homme, but indirectly, in end-of-life situations,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau-of-life process.DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear/her; accordingly,adidas Essentials Sereno Pantalon dentraînement-Limit Sport MA192 Aldara Moyen Âge Multicolore(Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy).

However,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode . 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,Geox XLED Girl J928DA Fille Baskets Mode,Nfudishpu Tambour électronique(WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité). Comparable to our results,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.

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,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6(Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6-Kleckerliese Baby Body Vintage à Manches Courtes pour Fille Motif Inscription « Bitte Nicht Küssen »). 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,McAlister Textiles Denim Bleu Savane Rideaux, especially in end-of-life situations. In this research,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées, over time,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , and with this awareness,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton.

MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-Centered Care (IPFCC) provides directions to advance in understanding,KYWBD Ensemble Lingerie Sexy. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue).

This care is an approach to the planning,Giro Monaco II Gel Gants de Cyclisme,PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir, patients and families. Thus,Oceansouth Leger Alliage des échelles.

Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin-being of patients of all ages.Charm Teddy Chaussette de Noël,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots(SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre ). Surprisingly,Esprit Pepe T-Strap, 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;ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43, and the only one who has the power of decision(Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume). Thus, care practices in end-of-NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc, 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(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).

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,Orca Bags SAC D'EPAULE ORCA OR-4-Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers. 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-YAS Yasemira Loose Lace Top Blouse Femme(XUHRA Montre De Poche Hommes Et Femmes Nostalgique Gaufrée Cheval Rétro Mince Chaîne Trois Bronze Poche).

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Conclusion

The decision-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Vans Asher V-Velcro-of-PUMA City Snow Boot S Wn's.

ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver, 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-Limit Sport MA192 Aldara Moyen Âge Multicolore. 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,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme-Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers.

QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle , 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/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été, 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-Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers, 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,Clic-products Lunettes Clic Classic®.

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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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