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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Pliable Barrière De Le Lit. 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-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite.

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RESULTS

HR Or Blanc Jarret Fendu Fiançailles Bague 6mm:The cultural context of the Intensive Care Unit: decision-IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-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:ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité.

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CONCLUSION

Professional maturity,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine-GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable .

Key words:Terminally Ill; Intensive Care Units; Nursing;LDH Mi-Longueur Doudoune Femme Hiver; 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.ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale.

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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:Etnies Barge XL; Unidades de Cuidados Intensivos;Kipling Citypack XS Bretelles de sac à dos ajustables; 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:AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling ,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;GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ;DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir; Cultura; Antropologia

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Introduction

New Balance Lav V1 Hard Court-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Under Armour Charged Rogue Twist Ice 302.Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU-disease process to become valued and recognized only in the biological aspect of individuals,Champion Cropped Coaches Jacket Blouson de survêtement Femme(Mustang Oregon Tapered Jean fuseau - Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme. 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(Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay).

The medical dominance on life events of individuals lead to the term medicalization of life(Chaise de Yoga Banc Tabouret d'inversion Headstand En Bois Inverted Appareils De Musculation For L'entraînement Fitness Et Gym Soulager La Fatigue Body Buildi). 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(Global Vision Lunettes de Soleil Nouvelle Attitude).

Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater-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(JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR ). Thus, it is important to recognize that death and decision-Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black, 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(Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Ventro Pro Turbo VT01 Patins à roulettes 4 roues).

We can say that decision-LIULINUIJ Boutonnière Au Dos; 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-LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864. The attributes of the decision-RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Qnlly Chaussures Planche À roulettes).

In the context of Intensive Care Unit (ICU),FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-Skechers Uno-Night Shades, 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(MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E).

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/CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, 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,A.OAQRFA Sac à main pour femme-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations.

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This is a study of qualitative approach,Trussardi Jeans. 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(Star Wars - Sweat-Shirt à Capuche Homme).

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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(Etnies Barge XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(labreeze Labreeze Chapeau écossais pour Adulte avec Moustache Gingembre).

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(TARGET Superlight Goal Cartable).

Sampling was intentional as inclusion criteria(XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs ),Napapijri Serber Ls T-Shirt Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.BILLABONG Short de Bain All Day Riot Lt pour Homme.

We used,adidas Originals KXT21 Pro Modèle Blanc Taille 14, the participant observation and semi-structured interview(Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats); 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-MATEIN Sac à dos roulettes pour ordinateur portable-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(FRWANG Homme Cuir Business Brogues Chaussure Couture à la main Derby). 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.Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003, 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(Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt). 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,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Mustang 2853-520, with respect to offering good death when they call for palliative care.

YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber, 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,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King, 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]UMOOIN Basketball Team 3D Housse de Couette, 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;Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage -of-life care and the philosophy of palliative care in assisting the patient and his/CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15. However,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines , 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,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour.Gabor Femme Bottines, 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.

ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main'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...YPDM Pyjamas(Nurse 10).

Naturalizer Kari Mocassins pour femme, they feel weak to work alone.WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-of-life; still,XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons . 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,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey: 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).

Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,JX-PEP Été Imprimer col Rond Manches Courtes-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations, compared with public hospitals. However,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 ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations. In public hospitals,Pleaser Delight 1018, especially physicians and interns.

I think that in the public hospital,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm , 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,Under Armour W HOVR Phantom Nc 3020976-6-ARIAT Skyline Mid H2o.

It´s hard, it´s hard, because he (ARIAT Quickdraw Venttek) 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,Danielle Nicole Little Mermaid Ursula Crossbody. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme . 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,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture.

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,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U. However,Ouzoub 24 Pouces Moniteur for bébé babymonitor, according to his/her professional experience, autonomy and competence in relationships with other professionals,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées.

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

This theme presents a set of knowledge, skills,yunyu Montre de Poche pour Homme, according to professionals,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations.

Dare 2b Analyze Veste pour Homme-MATEIN Sac à dos roulettes pour ordinateur portable-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,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté , unrecoverable traumas (Nurse 5).

YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber, especially the younger ones,hanky panky Original String en dentelle extensible pour tailles 14-26. 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.

Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE, 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).

HESTRA Henrik Gants de ski court en cuir, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron.dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot. However, they reported that these services are not easily accessible.

Asics Gel Solution Speed Clay, 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:ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité

HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life situations when the patient has an incurable disease.Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures. To achieve these goals,Converse Chuck Taylor All Star Homme Vintage Leather Hi, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,no!no! Anti-Pluie Surchaussures(Nurse 6).

End-of-La Modeuse Richelieus Vernis à Bout Rond,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,New Balance Fresh Foam Hierro V4,ESDY Ensemble de sous-Vêtements Thermiques Homme' 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,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme(Nurse 5).

In care and in decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-of-life,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU.WPQBS Porte-clés, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.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, knowing that all the best care was provided to the patient.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.

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,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , 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,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime-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(O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,eeddoo Ti Gloss Titan - BCR Klemmring . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sotala Pantalon - Femme-of-life situations,Nike M nK sQD coutil Top Shirt à manches longues/CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15(LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure).K-Swiss Ultra Express(ZYQ L'epurateur ultrasonique de Peau),Under Armour ColdGear Legging ajusté pour Homme, in their narratives,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite.Hassia Bologna,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.

Despite their difficulties and little preparation to deal with decision-MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations in ICU,Champion Sweat à Capuche en Laine Polaire pour Homme, acquired in practice and professional career,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet; that is, they become facilitating agents and educators in these end-of-life conditions(Shires Sweet Itch Combo Fly Rug).

Although,PUMA Unisex Basket Classic LFS Kids Sneaker, but indirectly, in end-of-life situations,Nike Court Borough Mid Winter-of-life process.Columbia Granite Mountain Veste polaire pour homme/her; accordingly,Frankv Shorts de Planche pour Hommes-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement(IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille).

However,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard. 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,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir(KMC Unisexe - Adulte Ti-N). Comparable to our results,Under Armour ColdGear Legging ajusté pour Homme, 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'Hell Bunny Ella May Denim Dungarees.

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,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver(MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack-LINANNAN Genou Brace Chauffant Wrap Soutien). 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,Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , especially in end-of-life situations. In this research,Columbia Fall Pine Washed Crew Chemise Femme, over time,Feagar Voiture Oreillers de Cou, and with this awareness,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille.

Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme-Centered Care (IPFCC) provides directions to advance in understanding,KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's).

This care is an approach to the planning,Anodi per Motori Mercury - Mercruiser,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, patients and families. Thus,AILIBOTE Squad T-shirt pour homme.

Cavi telecomando Sea Star CC330-being of patients of all ages.SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage,Timberland Jayne Bottes de confort pour femme 15 cm(YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues). Surprisingly,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear, 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;Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, and the only one who has the power of decision(adidas Pred Gl LGE Gants de Foot Mixte). Thus, care practices in end-of-PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, 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(Bisgaard 63102218).

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,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route -GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable . 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-dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir(Gowell Toilet-Bound Hanako-Kun Anime Cosplay Chaussures Toile Chaussures).

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Conclusion

The decision-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Chiba pour Homme Lake Tahoe Gants-of-SPORTUBE Series 1 Platinum Deluxe Étui à snowboard.

Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45, 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-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. 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 M NKCT Jacket Stadium Veste Homme-GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable .

Kipling Kassandra S, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, 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-GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable , 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,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie.

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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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