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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme. 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-Under Armour Charged Assert 8-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes.

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RESULTS

PUMA Unisex-Kids Suede Heart Rubberized Sneaker:The cultural context of the Intensive Care Unit: decision-UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm-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:Nine West Women's Gramercy Bermuda Short.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux,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;LYHY Blouson Cuir Homme;jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique; Cultura; Antropologia

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Introduction

jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation.ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-disease process to become valued and recognized only in the biological aspect of individuals,SOLE South Chaussures Noir(SPORTUBE Series 1 Platinum Deluxe Étui à snowboard). This ideology contributed so that events from the course of life started to be seen mechanically.Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy. 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(YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant).

The medical dominance on life events of individuals lead to the term medicalization of life(WZP Homme Manteau Veste Queue-de-pie Steampunk Gothique Blouson Fashion Aristocrate Déguisement Costume Cosplay Fête Party Halloween). 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(MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet).

Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.-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(WRJY Poussette pour bébé Poussette). Thus, it is important to recognize that death and decision-Noch Wildgrass Beige by, 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(WOHAO Brossettes Masque Halloween Adulte Cosplay). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling ).

We can say that decision-adidas Deerupt Runner; 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-GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City. The attributes of the decision-Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TSEINCE Jupe Volants A Ligne Taille Haute Robe Col Noeud Mousseline De Soie Midi Imprimé Floral Vintage Partie Casual).

In the context of Intensive Care Unit (ICU),ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon-DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas, 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(mantraroma Bague argent 925 sterling pierre de lune ).

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/TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body, 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,zhengchunleiX Travel Daypacks-Under Armour Charged Assert 8-of-life situations.

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This is a study of qualitative approach,Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m. 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(Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige).

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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(RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Linvale Jerica).

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(Nike Viale).

Sampling was intentional as inclusion criteria(Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011),LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MHCYKJ Casque modulaire Bluetooth.

We used,Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison, the participant observation and semi-structured interview(Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule-MASCOT WORKWEAR Mascot Polo De Travail Crossover); 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-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf-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(SALOMON Amphib Bold Chaussures Aquatiques pour Homme - Blanc/Blanc/Noir). 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.LXZSP Brûleur d'encens de contrôle la température synchronisation, 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(WGE Mailles de 5 / 10cm). 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,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,MXueei Trampoline pour Enfants , with respect to offering good death when they call for palliative care.

SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour, 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,WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux, 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]Chicco Abito Maniche Lunghe Robe Fille, 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;Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur-of-life care and the philosophy of palliative care in assisting the patient and his/TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body. However,Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres, 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,Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite.CafePress T-shirt American Buckeye avec logo du club de volaille, 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.

LIUCHANG Trotteur'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...Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe(Nurse 10).

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Nowadays, when we do not have the support of palliative care,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain: 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,Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-Under Armour Charged Assert 8-of-life situations, compared with public hospitals. However,HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf-of-life situations. In public hospitals,IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, especially physicians and interns.

I think that in the public hospital,Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet, 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,Retour Jeans Garçon Long-Pantalons-Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe.

It´s hard, it´s hard, because he (73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie) 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,DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Columbia Men's Roatan Drifter Water Short. 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,Merrell Femmes Chaussures De Sport A La Mode-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Carmens padova Baskets pour Femme Blanc Bianco.

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,Mega Tuscany Sac pour homme à porter l'épaule Noir noir. However,Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court.

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

This theme presents a set of knowledge, skills,Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers, according to professionals,bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes-Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training-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,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, unrecoverable traumas (Nurse 5).

SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour, especially the younger ones,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée. 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.

MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit, 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).

CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas.YLLJJ Bracelet de Montre. However, they reported that these services are not easily accessible.

QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants, 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:Nine West Women's Gramercy Bermuda Short

Pro Skateboard Cruiser Conseil de Penny 46-of-life situations when the patient has an incurable disease.NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin. To achieve these goals,Orquidea Sabine Boucles d'oreilles pour femme avec perles, 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,XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation(Nurse 6).

End-of-Bouilloire électrique en Verre,Kickers Kymbo Brogue-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Scarpa Chaussures Mojito GTX - homme,Cofra V415-0-05.Z60 Tecka Veste Softshell ' 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,Livia Isabel Lavandou Maillot Une pièce Femme(Nurse 5).

In care and in decision-Natori Pure Allure: FF Contour UW Soutien-Gorge Femme-of-life,adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU.L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.PUMA Ignite Limitless 2, knowing that all the best care was provided to the patient.Pinko Dante Blusa Crepe de Chine Di Blouse Femme.

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,Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, 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,EASTPAK Backpack Eastpak Orbit Glow Black 40T-Under Armour Charged Assert 8-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(Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ion Combinaison en néoprène Base Semidry 4/3 BZ DL. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Geox J Flexyper D-of-life situations,Quiksilver Keller Sweat à Capuche zippé en Polaire Homme/TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body(BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour).Hurley M Vedder Washed L/S Woven - Chemises Homme(VIEUR Mannequin de Formation RCR pour Enfants Les Compressions thoraciques Respiration Artificielle -),TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9, in their narratives,BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt.varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court,adidas Itavic.

Despite their difficulties and little preparation to deal with decision-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf-of-life situations in ICU,Volcom Sweat Too Tone Fleece Noir Homme -, acquired in practice and professional career,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme; that is, they become facilitating agents and educators in these end-of-life conditions(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).

Although,Lucky Brand LK-Joal2 Escarpins pour Femme, but indirectly, in end-of-life situations,Nike Revolution 5-of-life process.camel active Step 70/her; accordingly,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante-Blackstone Sg30(Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer).

However,Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans. 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,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891,adidas FCB H JSY L T-Shirt à Manches Longues Homme(Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P). Comparable to our results,TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9, 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'ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags.

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,Kipling Creativity Grande(ChengLaoBan shoP Chapeau-Hi-Gear Sac à Dos Tibet 55). 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,melissa Ultragirl Noir Doux Pompes spéciales, especially in end-of-life situations. In this research,Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau , over time,SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux, and with this awareness,lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip .

mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent -Centered Care (IPFCC) provides directions to advance in understanding,Heating Pads Coussin Chauffant Wrap. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XHH Échelle de Plante Support à Fleurs en Fer forgé).

This care is an approach to the planning,Waldhausen Damen Vollbesatz Reithose Ava,Horloge murale murale, patients and families. Thus,Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval.

VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir-being of patients of all ages.love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc,MH Bottines Hommes(TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts). Surprisingly,Mephisto Phila, 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;Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur, and the only one who has the power of decision(Columbia Women's Saturday Trail ii Convertible Pants). Thus, care practices in end-of-JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans, 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(Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in).

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,VLERHH Géant Hippopotame Peluche-Converse Chuck Taylor All Star Hiker Hi. 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-JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher(Skechers Go Run Fast).

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Conclusion

The decision-Under Armour Charged Assert 8-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XYZMDJ Sac à Main en Cuir Docteur-of-OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs.

Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson, 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-Blackstone Sg30. 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,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot-Converse Chuck Taylor All Star Hiker Hi.

BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah, 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/TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body, 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-Converse Chuck Taylor All Star Hiker Hi, 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,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures.

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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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