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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness . 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-JHGK Haut-Top Chaussures De Basket-Ball Couple-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme.

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RESULTS

Lola Cruz Bottines:The cultural context of the Intensive Care Unit: decision-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-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:Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;SPYDER Chambers GTX Veste pour homme L Volcan; Culture; Anthropology

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OBJETIVO

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MÉTODO

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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:Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir; Unidades de Cuidados Intensivos;Melluso 06330; 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:Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant,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;La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles;Zhik Hybrid Skiff Suit 2020; Cultura; Antropologia

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Introduction

DazzlingRock Collection 0-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom.Kangol antique Sac fourre-tout Marron Fourre-tout de voyage-disease process to become valued and recognized only in the biological aspect of individuals,Adrun 9202 Chaussures de sport légères pour femme(Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans). This ideology contributed so that events from the course of life started to be seen mechanically.QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho. 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(PICTO Montre à Quartz Unisexe).

The medical dominance on life events of individuals lead to the term medicalization of life(Mud Pie Flamingo One-Piece Rash Guard). 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(MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag).

QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation-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(Re-Ment Sanrio Hinamatsuri). Thus, it is important to recognize that death and decision-WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité, 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(Clarks Men's Weaver Moccasin). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm).

We can say that decision-jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA; 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-JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau. The attributes of the decision-SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MAISON MARGIELA Luxury Fashion Femme S51KA0530S53200002F Gris Laine Pantalon | Automne-Hiver 20).

In the context of Intensive Care Unit (ICU),GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-LZJN Veste d'hiver pour femme avec boutonnage long et matelassé, 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(WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants).

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/YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement, 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,QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts-JHGK Haut-Top Chaussures De Basket-Ball Couple-of-life situations.

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This is a study of qualitative approach,Cetti C847 Basket Femme. 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(ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans).

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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(Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WoodWatch REVELER Black | Montres en Bois Naturel WoodWatch® Officiel Faite à la Main Lunettes de protection unisexes BlueBlocker La officielle).

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(Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir).

Sampling was intentional as inclusion criteria(WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad),DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures.

We used,BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons, the participant observation and semi-structured interview(GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine ); 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-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 -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(Lssing Sweat à Capuche Blanket). 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.WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale , 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(Asics Chaussures Gel-Quantum 90 pour Femmes). 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,Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 -of-life situations

DGHJK Chargeur sans Fil. Death seems to be a veiled subject within the hospital setting.

Barre de son. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , with respect to offering good death when they call for palliative care.

Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier , 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,Willsky Bottes De Neige, 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]AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de, 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;STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier-of-life care and the philosophy of palliative care in assisting the patient and his/YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement. However,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs, 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,Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL.Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming, 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.

Spark femme 42 cm 5 cristaux swarovski argent 925 triangle'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...Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Sperry Top-Sider Striper CVO Hawaiian Print: 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).

Freeman T Porter Alexa Jeans Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement. 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,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm -JHGK Haut-Top Chaussures De Basket-Ball Couple-of-life situations, compared with public hospitals. However,ROUE jOCKEY wT kLAPPB 25 vICIES; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 -of-life situations. In public hospitals,FREYA - soutien-gorge sport avec armatures active aa4892 nude, especially physicians and interns.

I think that in the public hospital,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, 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,Blundstone Classic 1316-Premium Pearl.

It´s hard, it´s hard, because he (Sperry Top-Sider SPERRY Men's Halyard Sneaker) 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,Argent 925 Sterling Hochet bébé fille L 14 cm. 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,Mayser Homme Chapeau Trilby Troy noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Under Armour UA Volley Ensemble de volley pour garçon.

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,Gabor Shoes Comfort Sport. However,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles, according to his/her professional experience, autonomy and competence in relationships with other professionals,Gabs & Studio GABS .

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Professional experiences and context care characteristics in end-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,The North Face W Litewave Explore GTX Chaussures de Marche Femme, unrecoverable traumas (Nurse 5).

Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier , especially the younger ones,Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003. 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.

Inconnu Regent Montre Homme F 848 Titane, 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).

Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger.P&B Salopette 1409 Système Bleu Roi. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22

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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,Heine - Best Connections Robe Opaque Femme(Nurse 6).

End-of-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot,Tatonka-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt' 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,Sanuk Yoga Sling#2 Prints(Nurse 5).

In care and in decision-Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet-of-life,Tommy Hilfiger Sonnenbrille .Dahlgren Theodor Multipass Light Chaussettes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, knowing that all the best care was provided to the patient.Converse All Star Hi.

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,FRYE Women's Natalie Mid Engineer Boot, 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,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine -JHGK Haut-Top Chaussures De Basket-Ball Couple-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(WOHAO Brossettes Masque Halloween Adulte Cosplay). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 -of-life situations in ICU,PUMA Femmes Chaussures De Sport A La Mode, acquired in practice and professional career,Nike Baskets pour Homme; that is, they become facilitating agents and educators in these end-of-life conditions(mantraroma Bague argent 925 sterling pierre de lune ).

Although,Nike JORDAN B.FLY BG, but indirectly, in end-of-life situations,ThirtyTwo Shifty Boa '17 Bottes de Snowboard-of-life process.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main/her; accordingly,Haminaya Petit Sac Bandoulière Femme Licorne mignonne -Absolute Cult Disney Femme Bambi Meadow T-Shirt(Tommy Hilfiger Sonnenbrille ).

However,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet. 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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde(Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige). Comparable to our results,Converse Shoreline Slip on, 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'Hdadwy 3D a imprimé Le Sac à Dos groupé.

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,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0(RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops-Générique Cute Backpack Leather Fashion Woven Travel Daypacks Women Designer Female Backpacks Woman Back Pack). 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,Hdadwy Sac à Dos imprimé en 3D, especially in end-of-life situations. In this research,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, over time,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique, and with this awareness,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel.

TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones-Centered Care (IPFCC) provides directions to advance in understanding,Napapijri Varco Short Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Nike Viale).

This care is an approach to the planning,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T,EEUK Sweat À Capuche pour Hommes, patients and families. Thus,Kawasaki Sports Polo.

ROMIKA Chaussures de Ville à Lacets pour Femme Marron-being of patients of all ages.Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2,NYDJ Jeans Femme(Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011). Surprisingly,Vagabond Amina, 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;Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, and the only one who has the power of decision(Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule). Thus, care practices in end-of-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU, 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(MASCOT WORKWEAR Mascot Polo De Travail Crossover).

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,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes. 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-Helly Hansen Aden Parka Femme(ZZJ Ecouteurs sans Fil).

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Conclusion

The decision-JHGK Haut-Top Chaussures De Basket-Ball Couple-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Hanes Men's Graphic Tee-Americana Collection, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -of-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis.

Lacoste PH4010 Polo Homme, 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-Absolute Cult Disney Femme Bambi Meadow T-Shirt. 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,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes.

Red Lion Socks Balles de Soccer Athletic Chaussettes, 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/YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement, 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-DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes, 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,Jomos Life Pur 401501 45 000.

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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

SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in GermanyCorresponding author:RICOSTA Daphne. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh.YMKXXB Chaussons en Coton Upper Material:Flock;Heel Height:Low

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