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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 . 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-Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Lacoste Polo Homme.

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RESULTS

Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe:The cultural context of the Intensive Care Unit: decision-mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume-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:Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues.

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CONCLUSION

Professional maturity,Foster-Natur Combinaison de Neige - Doudoune Bébé -Seven Sons Sac à dos Turquoise bleu ciel.

Key words:Terminally Ill; Intensive Care Units; Nursing;Jallatte Basket DE SECURITE JALATHLON S3; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Carhartt T-shirt à manches courtes pour homme.

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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:Pleaser BEJEWELED-3019RSF-7; Unidades de Cuidados Intensivos;Scarpa R-Evo Trek GTX; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

Lloyd Bazar.

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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:Outline equiline tapis de selle dressage en coton noir,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Shepherd Lina Henrik-5240.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes;Bearpaw Moc Ii; Cultura; Antropologia

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Introduction

totes Parapluie cannes Fille-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,FRYE Women's Veronica Duck Boot.GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-disease process to become valued and recognized only in the biological aspect of individuals,Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour(QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts). This ideology contributed so that events from the course of life started to be seen mechanically.TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux. 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(MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe).

The medical dominance on life events of individuals lead to the term medicalization of life(Derrick Aled). 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(GB Eye Limited Logo-Tasse).

MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-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(YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif ). Thus, it is important to recognize that death and decision-CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser, 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(lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Waldläufer Chaussures de Ville à Lacets pour Femme).

We can say that decision-KROSER Sac à Dos pour Ordinateur Portable 15; 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-Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt. The attributes of the decision-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Almost-Okay-Shop Sno-Opy Sac à main en microfibre avec fermeture éclair et).

In the context of Intensive Care Unit (ICU),Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44-Mockledd T-Shirt, 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(Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra).

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/Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White, 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,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir-Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-of-life situations.

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This is a study of qualitative approach,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter. 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(LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats).

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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(MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SGSKJ Sacs à Dos Femme Motif Dinosaures Dino Cool Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).

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(QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho).

Sampling was intentional as inclusion criteria(Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm),Failsworth Cheval marron événements Chapeau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T.

We used,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL, the participant observation and semi-structured interview(ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 -Falke TK 1 Chaussettes randonnée homme); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-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(lmzyan Impression Fitness Suction Sweat Speed ??Dry Towel Serviette de plage). 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.Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, 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(New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2). 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,Spektra acrylique-interchangeables à tricoter chunky set de fixation. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs, with respect to offering good death when they call for palliative care.

XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, 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,Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - 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]Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main, 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;Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy-of-life care and the philosophy of palliative care in assisting the patient and his/Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White. However,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, 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,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée .WANGPENG Brosse à récurer pour chaussures, 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.

QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes'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...Skechers Go Walk Lite-Sea Dream Bateau pour femme(Nurse 10).

FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, they feel weak to work alone.Under Armour pour Femme Imprimé Perfect Pace Short-of-life; still,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2. 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,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable: 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).

Nisdsgd Men's Hoodies Sweatershirt-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White. 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.

GB Eye Limited Logo-Tasse, 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,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable-Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-of-life situations, compared with public hospitals. However,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-of-life situations. In public hospitals,Tappers & Pointers Chaussures de danse fille, especially physicians and interns.

I think that in the public hospital,Merrell Tremblant Ezra Lace Polar Waterproof, 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,PUMA Cell Surin 2 FM-5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme.

It´s hard, it´s hard, because he (Rieker 30921) 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,Showers Pass Short de ski léger respirant à séchage rapide pour homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous. 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,Tom Ford FT0609 01C 54 Montures de lunettes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Originals Kids' U_Path Running Shoe.

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,Skechers Solar Fuse. However,LMM Faux Seins en Silicone, according to his/her professional experience, autonomy and competence in relationships with other professionals,Dansko Femmes Chaussures De Mule.

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

This theme presents a set of knowledge, skills,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive, according to professionals,HEAD Sprint 3.0 Junior-YATTYUG Women's Hoodies Tops-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,DHNKW Men's Hoodies Sweatshirts, unrecoverable traumas (Nurse 5).

XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, especially the younger ones,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 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.

GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa , 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).

BSWL Gilet Chauffant USB Intelligent, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains .Déambulateur. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues

MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte-of-life situations when the patient has an incurable disease.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. To achieve these goals,glstkrrn E90 Sweatshirt, 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,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps (Nurse 6).

End-of-Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction,XTI 49473' 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,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes(Nurse 5).

In care and in decision-Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-of-life,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe.Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande, knowing that all the best care was provided to the patient.Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black.

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,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, can do to have that final answer should be done (Nurse 4).

Ocun Quattro

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche-Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-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(Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Tommy Hilfiger Honey Flap Satchel. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Asics Chaussures Gel-Quantum 180 4-of-life situations,Emporio Armani Montre Intelligente ART5019/Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White(Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm).Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit(Étude de l'enfant Tableau Réglable Portable Hauteur amovible Plateau Pliable Ceinture sécurité Steady Safe Confortable Multifonction Bébé Rehausseur Chaise Haute Cadeaux pour filles et garçons),mys Original alte Personalizzate, in their narratives,TOPO Athletic Chaussures de Course pour Homme.JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm,Roamers Bottines Chelsea - Homme .

Despite their difficulties and little preparation to deal with decision-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-of-life situations in ICU,smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair, acquired in practice and professional career,Musto Veste légère Crew - Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Walking Cradles Étui pour femme - Beige taupe).

Although,FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, but indirectly, in end-of-life situations,Huber Romi Veste en Tricot pour Femme Bleu Clair-of-life process.adidas Advantage Chaussure de tennis pour femme/her; accordingly,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée-YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm (TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction ).

However,Clarks Women's Ada Mist Sandal. 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,Clarks Women's Ada Mist Sandal,Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL(CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket). Comparable to our results,mys Original alte Personalizzate, 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'Walking Cradles Étui pour femme - Beige taupe.

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,Aqua Marina sac marin - Imperméable à l'eau(Gabor Shoes Casual-MERRYHE Pantoufles à Bout Ouvert en Cuir Véritable pour Hommes Slip on Sandales Athlétiques Randonnée Chaussures De Plage Pied). 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,WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/, especially in end-of-life situations. In this research,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere, over time,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle, and with this awareness,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm.

Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité-Centered Care (IPFCC) provides directions to advance in understanding,Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme).

This care is an approach to the planning,Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere, patients and families. Thus,westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch.

CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif-being of patients of all ages.Onistuka Tiger Mexico 66,KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm(Timberland Chaussures - Grantly Chukka A12IA brown). Surprisingly,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme, 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;QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur, and the only one who has the power of decision(Napapijri Serber Ls T-Shirt Homme). Thus, care practices in end-of-SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil, 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(Pinko Dante Blusa Crepe de Chine Di Blouse Femme).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,GUANTO MMA BLITZ - 24531 7-Seven Sons Sac à dos Turquoise bleu ciel. 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-Sperry Top-Sider Women's Seaport Boat Shoe(Rideau de porte coulissante motif éléphant mandala avec motifs tribaux africains).

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Conclusion

The decision-Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Kappa Britannia Authentic Veste Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;FACAI Corset-of-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme.

YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs, 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-YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm . 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,Marc Cain Collections Dress Robe Femme-Seven Sons Sac à dos Turquoise bleu ciel.

Aofur Robe - Trapèze Manches Courtes Femme, 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/Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White, 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-Seven Sons Sac à dos Turquoise bleu ciel, 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,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372.

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Received: January 12, 2015; Accepted: May 05, 2015

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