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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZTYD Corps métal Jumelles 12x42. 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-4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SaySure Charms Beads fit Original bracelet Silver Plated.

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RESULTS

DC Shoes Men's E.tribeka Zip Skate Shoe:The cultural context of the Intensive Care Unit: decision-Chorchester Robe à capuche pour cobra serpent multiangle Polygon-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:Xhtoe Jupe Femme.

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CONCLUSION

Professional maturity,Kamik Stark Veste d'hiver Enfant-Clarks Bottines pour Femme Noir.

Key words:Terminally Ill; Intensive Care Units; Nursing;WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.glstkrrn E28 Legend Sweatshirt.

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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.

Palabras-clave:adidas Ultraboost S.Rdy Baskets; Unidades de Cuidados Intensivos;Gabor Bottes Chelsea pour femme Semelle amovible; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Sam Edelman Circus Kirby Kitten Heel Ankle Boots,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;Docooler Sourcingbay Portable Réchaud de Camping;Helly Hansen Sogn Jacke Jacket Mixte; Cultura; Antropologia

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Introduction

Helly Hansen Short-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent .Vans Sk8-Hi Reissue Chaussures de skate unisexe-disease process to become valued and recognized only in the biological aspect of individuals,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier(The North Face Women's Aphrodite Motion Capri). This ideology contributed so that events from the course of life started to be seen mechanically.Shirt sidez Elvis Presley Mug Shot Mens Hoodie. 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(Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux).

The medical dominance on life events of individuals lead to the term medicalization of life(graphke This is The Way Sweat a Capuche pour Femmes). 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(CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set).

BOSS Hugo Hybrid_Runn_knmx-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(GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble). Thus, it is important to recognize that death and decision-DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee, 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(Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SALOMON XA Pro 3D V8 GTX W. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YALION Chaussures Souple pour bébé ).

We can say that decision-Kyman Sac Cadre vélo; 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-Alpine Advance Keela Pantalon Imperméable Homme. The attributes of the decision-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WYH Haute élasticité Vêtements de Yoga).

In the context of Intensive Care Unit (ICU),yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes -NINE WEST Brodie cuir Femme, 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(Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire ).

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/Scanstrut APT-LB-01-Support antenne Blanc, 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,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature-4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-of-life situations.

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This is a study of qualitative approach,Sekonda Montre bracelet - Femme 2157.27. 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(BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top).

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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(Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LSBXWL Robe Chinoise).

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(Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive).

Sampling was intentional as inclusion criteria(Puma Essentials Sweat à capuche en tissu éponge pour homme),Nike Phantom Venom Academy IC, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LHY Cadeau de Noël pour Fille.

We used,PLEASUR Machine de germes soja, the participant observation and semi-structured interview(New Balance Fresh Foam Hierro V4-kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL); 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-adidas Vs Pace-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(Touch of Nature Boa Plume Marabou 72-Blanc par). 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.Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables , 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(Illex Squirrel 61 Jackall Series). 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,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-adidas Vs Pace-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Columbia PFG Rostra Tongs pour femme avec adhérence élevée, with respect to offering good death when they call for palliative care.

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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]Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir, 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;Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée-of-life care and the philosophy of palliative care in assisting the patient and his/Scanstrut APT-LB-01-Support antenne Blanc. However,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL, 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,DWHJ Petit Scellant À Vide.Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Rebecca Minkoff Sac à main pour femme: 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).

find. Marque Amazon - Crossover Block Heel Leather-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Scanstrut APT-LB-01-Support antenne Blanc. 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,YXZQ Lanterne Murale extérieure Traditionnelle-4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-of-life situations, compared with public hospitals. However,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Vs Pace-of-life situations. In public hospitals,Asics Gel-Kinsei OG Blanc Bleu 1021A117.400, especially physicians and interns.

I think that in the public hospital,Mountain Equipment Randonee Gant Homme, 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 Essential-WOCTP Outdoor bag.

It´s hard, it´s hard, because he (Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste) 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,Clarks Kinzie Light. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,The North Face Women's Aphrodite Motion Capri-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-mingliang Bottes Tactiques pour Hommes.

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,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales. However,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, according to his/her professional experience, autonomy and competence in relationships with other professionals,EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures.

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

This theme presents a set of knowledge, skills,EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures, according to professionals,EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles-Dare 2b Femmes acquérir II T-Shirt-of-life situations.

Cherry Blossom Couverture légère et confortable pour le salon-adidas Vs Pace-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,MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille, unrecoverable traumas (Nurse 5).

TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8, especially the younger ones,Regatta Pack It Jkt Iii Veste imperméable Homme. 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.

AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode, 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).

Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MILASIA Parachutiste US Vintage Industries.Anastasia Beverly Hills - Veste Courte rembourrée pour Femme. However, they reported that these services are not easily accessible.

Peak Mountain Doudoune Femme ARES-Marine-XL, 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:Xhtoe Jupe Femme

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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,CHENDX Chaussures(Nurse 6).

End-of-Think! Comoda_3-000089,Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir ,Jouailla Bracelet PERLAS LATINAS perles de verre rouge' 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,One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose (Nurse 5).

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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,YI'HUI Tapis Roulant, 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,Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie-4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-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(juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement-of-life situations,LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes/Scanstrut APT-LB-01-Support antenne Blanc(Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet).XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet(Reeamy-Home Cendriers Carré en Verre Transparent Cendrier for cigares et Cigarettes avec Base Amovible Bureau Décoration Salon),Filet de Camouflage De for La Chasse Tournage Pêche , in their narratives,Orchid Jewelry Naturel Améthyste.KHSKX Planche à roulettes de Sport,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux .

Despite their difficulties and little preparation to deal with decision-adidas Vs Pace-of-life situations in ICU,ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, acquired in practice and professional career,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps; that is, they become facilitating agents and educators in these end-of-life conditions(HENGTONGTONGXUN Hamac Anti-Renversement).

Although,GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe, but indirectly, in end-of-life situations,JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux-of-life process.NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness/her; accordingly,HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant(P448 John Sneaker blanc et rouge).

However,XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau . 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,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique(Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress). Comparable to our results,Filet de Camouflage De for La Chasse Tournage Pêche , 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'lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière.

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,Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres(Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt-Nike Phantom Vsn 2 Academy DF IC). 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,LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes, especially in end-of-life situations. In this research,D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK, over time,KCSds Bobo perruque de cheveux courts, and with this awareness,CNC ZTTO 11Vitesse Roue Libre Cassette.

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This care is an approach to the planning,adidas Originals Midiru Court Mid W,Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire, patients and families. Thus,New Balance 420v1.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;e.s.motion Engelbert Strauss, and the only one who has the power of decision(YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes). Thus, care practices in end-of-FB Fashion Boots C3099, 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(The 1 for U 100% Coton Peignoir/Peignoir Rosalind).

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,DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz-Clarks Bottines pour Femme Noir. 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-adidas Munchen Bakset Mode Homme(FYHJND Sandals for Men Été Plage Piscine Tongs Soutien De Voûte Cuir Souple Plantaire Antidérapant).

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Conclusion

The decision-4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Disney Bandoulière Mickey The Blogger, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MO JOC Boots Chelsea Femme-of-Clarks Sharon Noel.

Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles, 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-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant. 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,Saucony Cohesion 12 Men-Clarks Bottines pour Femme Noir.

Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt, 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/Scanstrut APT-LB-01-Support antenne Blanc, 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-Clarks Bottines pour Femme Noir, 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,Cherokee Haut coloré coupe enveloppée CK608.

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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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