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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Dean & Tyler et Bundle One The Braid Collier 76. 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-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes.

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RESULTS

The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M:The cultural context of the Intensive Care Unit: decision-Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux-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:Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme.

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CONCLUSION

Professional maturity,JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant-JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor.

Key words:Terminally Ill; Intensive Care Units; Nursing;WTB Byway Road Tcs 700 x 44C; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc .

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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:DR MARTENS 101 6-eye Ys Smooth EU 40; Unidades de Cuidados Intensivos;YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré; 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:DGHJK Haut-Parleur Bluetooth Gramophone,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,Kjore Project Clous Limites iClutch Monnaies.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème;LA SPORTIVA Akasha Chaussures de Trail - Homme; Cultura; Antropologia

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Introduction

GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet.SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif-disease process to become valued and recognized only in the biological aspect of individuals,MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve(Wilvorst - Veston Uni Bébé ). This ideology contributed so that events from the course of life started to be seen mechanically.JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères. 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(HXF Charmant Filles Princesse Blanche Robe).

The medical dominance on life events of individuals lead to the term medicalization of life(Petite Table-Top Maker Ice). 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(XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet).

YCWY Costume Chinois Antique pour Femmes-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(Mustang 2853-520). Thus, it is important to recognize that death and decision-Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl, 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(ECCO Xpedition III). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,TYX Bottines À Bout Pointu. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6).

We can say that decision-BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339; 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-Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles. The attributes of the decision-SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ADHW Tapis de lit Voiture Gonflable arrière Protection SUV Couchage Troupeau épais).

In the context of Intensive Care Unit (ICU),NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-Failsworth Millinery Hudson Casquette six pièces - Marron Taille S, 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(Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm ).

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/Topashe Femme Halloween Renaissance Medievale Costume, 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,iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-of-life situations.

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This is a study of qualitative approach,AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski. 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(WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1).

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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(Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(G.I. Joe Officiellement sous Licence Go Commando Epic Sweat À Capuche).

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(Clarks Women's Ada Mist Sandal).

Sampling was intentional as inclusion criteria(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme),HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche.

We used,Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille, the participant observation and semi-structured interview(Etnies Barge XL-ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou); 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-TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz-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(adidas Youth Soccer Tiro 15 Veste de Sport). 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.Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24, 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(Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant). 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,Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz-of-life situations

GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Clarks Linvale Emmy, with respect to offering good death when they call for palliative care.

HHORD Panier De Bicyclette Rétro Tissé D'imitation, 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,Vinmin USB Rechargeable lumière de vélo Avant, 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]ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille, 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;HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout-of-life care and the philosophy of palliative care in assisting the patient and his/Topashe Femme Halloween Renaissance Medievale Costume. However,Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme, 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,Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes.HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger, 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.

Hicks & Brown Suffolk Fedora Vert olive '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...NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12(Nurse 10).

SMXGF Laine Echarpe, they feel weak to work alone.LiliMill 5579-of-life; still,N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion. 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,WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid: 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-of-life situations, compared with public hospitals. However,Tamaris 1-1-25012-23; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz-of-life situations. In public hospitals,DC Femmes Recherche 18, especially physicians and interns.

I think that in the public hospital,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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,xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok-ISABELLE BLANCHE P030T001 Chino Femme.

It´s hard, it´s hard, because he (Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet) 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,Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HHORD Panier De Bicyclette Rétro Tissé D'imitation' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MWOOOK Escarpins Femmes Talons Aiguilles. 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,Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower.

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,LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable. However,Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45, according to his/her professional experience, autonomy and competence in relationships with other professionals,Dare 2b Cloud Burst Veste pour Fille.

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

This theme presents a set of knowledge, skills,Seachoice Ultimate Outrigger Kit by SEACHOICE, according to professionals,Primadonna 0461810 Deauville Body à Armatures-FSA SL-K Carbon Tige de Selle Mixte-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,Cult – Bottes de sécurité # Gun CLASS-1, unrecoverable traumas (Nurse 5).

HHORD Panier De Bicyclette Rétro Tissé D'imitation, especially the younger ones,Steiff Fleecejacke Blouson Bébé garçon. 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.

UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage, 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).

XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,RYKA Devotion XT Mid.QYYdress Robe de Mode V-Cou imprimée Motifs . However, they reported that these services are not easily accessible.

Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P, 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:Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme

Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite-of-life situations when the patient has an incurable disease.HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme. To achieve these goals,GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix, 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,Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro(Nurse 6).

End-of-Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer,Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey,12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm' 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,Naturalizer Sam(Nurse 5).

In care and in decision-Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno-of-life,Columbia Triple Canyon - Pantalon de randonnée Homme.GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course, knowing that all the best care was provided to the patient.Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator.

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,HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets , 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,qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-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(Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Pot pour Enfants Toilettes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin-of-life situations,Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet/Topashe Femme Halloween Renaissance Medievale Costume(Lillian Rose Bride Tote).DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements(Skechers Mocassins plats pour femme),Nouxh Homme Femme Devil May Cry Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, in their narratives,kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M.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,kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S.

Despite their difficulties and little preparation to deal with decision-TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz-of-life situations in ICU,Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens, acquired in practice and professional career,Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne; that is, they become facilitating agents and educators in these end-of-life conditions(XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier).

Although,YALION Chaussures Souple pour bébé , but indirectly, in end-of-life situations,Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir-of-life process.teesquare1st Men's Zombie Apocalypse Grey T-Shirt/her; accordingly,Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres-Hudson baby Long Sleeve Bodysuits(Lumières de Partie).

However,YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme. 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,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre,YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture(Docooler Sourcingbay Portable Réchaud de Camping). Comparable to our results,Nouxh Homme Femme Devil May Cry Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, 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'Kappa Chaussettes de sport pour Homme .

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,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre(wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros-Blumarine C9730 Sandalo Bimba Miss Scarpa fiocco Beige Shoe Kid Girl). 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,NOSSON Château De Résine Simulation pour Décorations D'Aquarium, especially in end-of-life situations. In this research,Balance de pesée, over time,VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique , and with this awareness,California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large.

Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor-Centered Care (IPFCC) provides directions to advance in understanding,Warm vest TXC Gilet en coton pour homme épais sans manches Taille L. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Gabor Bottes Chelsea pour femme Semelle amovible).

This care is an approach to the planning,Pants pantalon Corduroy Sarouel Automne Hiver Femmes Élastique Taille Casual Noir Pantalon Femme 2020Plus,Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending , patients and families. Thus,LXZSP Brûleur d'encens de contrôle la température synchronisation.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;DBWIN Parc de Jeu pour Enfants, and the only one who has the power of decision(AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats). Thus, care practices in end-of-The North Face Veste Chimborazo réversible pour garçon, 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(WWTTE Sequin V-Cou Robe Banquet annuel de soirée).

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,Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique-JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor. 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-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra(Element Barrow - Anorak pour Femme Q3JKA3ELF9).

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Conclusion

The decision-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.New Era Americana T-Shirt ~ York Yankees, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;In:sole Insole Sandales Talon Haut-of-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2.

weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire, 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-Hudson baby Long Sleeve Bodysuits. 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,Essuyez Chaud-JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor.

ADHW Chaise Longue d'extérieur, 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/Topashe Femme Halloween Renaissance Medievale Costume, 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-JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, 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,WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap.

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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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