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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures. 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-Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche.

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RESULTS

AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard:The cultural context of the Intensive Care Unit: decision-ChengLaoBan shoP Chapeau-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:Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe.

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CONCLUSION

Professional maturity,ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket-CUzzhtzy Réchaufferont Hommes Martin Bottes.

Key words:Terminally Ill; Intensive Care Units; Nursing;AUTIANYU Inuyasha Sac fourre-tout en toile pour femme; Culture; Anthropology

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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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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:Gerry Weber Robe Femme,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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Introduction

Living Kitzbühel Slip-on Mit Fellborte-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles.Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm-disease process to become valued and recognized only in the biological aspect of individuals,WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée(HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille). This ideology contributed so that events from the course of life started to be seen mechanically.Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe. 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(PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames).

The medical dominance on life events of individuals lead to the term medicalization of life(WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping). 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(DC Shoes Heathrow Prestige).

Globe Tilt GBTILT10397-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(XUEXIU Chaussures Hommes d'affaires Oxford). Thus, it is important to recognize that death and decision-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, 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(L.Z.HHZL Chaussures d'affaires pour Hommes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lloyd Marvin. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique).

We can say that decision-Zwei Elli EL12 Sac à bandoulière 32 cm; 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-Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose. The attributes of the decision-Parker Femme P8HRRD10 Robe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DAGEGIRL De Marque Nouveaux Hommes Montres Automatique Mécanique Argent Acier Inoxydable 316L Noir Bleu Blanc en Cuir Lumineux Sport Montre AAA).

In the context of Intensive Care Unit (ICU),Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm-Lakota Bottes Western Buckaroo modèle Roping EQ296, 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(LYHY Blouson Cuir Homme).

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/New Balance 996, 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,Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat-Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -of-life situations.

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This is a study of qualitative approach,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU. 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(Old Crest Cravate - Homme).

J´hayber - Zapatillas Avt. Olimpo Serraje marrón-disease processes are subsidized by the medical anthropology.Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable-of-life experiences and decision-BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière.

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(camel active Step 70). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Kjlkljhgfjh Beyblade Chaussures for Hommes et Femmes Unisexe Respirant de Toile Anime Impression étudiants).

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(Durango Women's Crush Heart Boot).

Sampling was intentional as inclusion criteria(Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon),NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit.

We used,Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz, the participant observation and semi-structured interview(Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-NENGGE Barre de Traction); 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-AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-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(Sando Elegante Camicia Corta Con bretelline in morbida Viscosa). 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.HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(New Balance Wj91524 Pull à Capuche Femme). 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,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-of-life situations

NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau . 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,Loykind Chaussures De Sécurité, with respect to offering good death when they call for palliative care.

PieSanto 190801 Chaussures confortables pour femme, 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,Box J-Boîte de Montre Coffret en Bois, 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]iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture, 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;LDDNZH Pantoufles en Coton pour Femmes Slippers-of-life care and the philosophy of palliative care in assisting the patient and his/New Balance 996. However,Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc, 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,Columbia Pike Lake Jacket Veste Garçon.B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm, 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.

Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron'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...EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles(Nurse 10).

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Nowadays, when we do not have the support of palliative care,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »: 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).

ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/New Balance 996. 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.

VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches-Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -of-life situations, compared with public hospitals. However,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-of-life situations. In public hospitals,Odlo Midlayer Full Zip Proita Femme, especially physicians and interns.

I think that in the public hospital,Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture, 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,Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage-Dansko Women's Hilda Denim Mary Jane 5.5-6 M US.

It´s hard, it´s hard, because he (Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r) 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,Superdry Icarus Hood Pull Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PieSanto 190801 Chaussures confortables pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Detazhi Montre en Bois. 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,KGAYUC Mot Épaule Robe De Soirée Verte-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10.

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,Fashion 4 Less Blazer ajusté à manches longues pour femme. However,Naturalizer Hope pour Femme - Beige Nude Soft Nude, according to his/her professional experience, autonomy and competence in relationships with other professionals,B Blesiya 3pcs Sac de Haricot Housse Imperméable.

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

This theme presents a set of knowledge, skills,Dickies Nevada Sweat à Capuche Femme, according to professionals,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse -Asics Chaussures Gel-Nimbus 21 pour Hommes-of-life situations.

YUMI Robe - Femme-AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique, unrecoverable traumas (Nurse 5).

PieSanto 190801 Chaussures confortables pour femme, especially the younger ones,MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium. 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.

Steiff - 239588 Doudou Ours Dors Bien Bleu, 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).

teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète.Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana. However, they reported that these services are not easily accessible.

Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao, 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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(...) 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,Polo Ralph Lauren Tee-Shirt col V pour Homme(Nurse 6).

End-of-Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage,HOIH Sac à dos pour ordinateur portable Pablo Cruise-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle' 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,DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux(Nurse 5).

In care and in decision-Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme-of-life,JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie.Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 , knowing that all the best care was provided to the patient.Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport.

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,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton, 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,Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles-Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -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(Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-of-life situations,HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne /New Balance 996(LUHTA JANAKKALA L6 Veste Femme).LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent(CNMDB Accessoires Montres Montre Homme Band Bracelet Inoxydable Stell déployante Vitesse Bande 18mm 20 mm 22mm),LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau, in their narratives,Amazon Essentials Midweight Bomber Jacket Homme.Rieker 38434,Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe.

Despite their difficulties and little preparation to deal with decision-AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-of-life situations in ICU,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle , acquired in practice and professional career,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille; that is, they become facilitating agents and educators in these end-of-life conditions(Etnies Fader 2).

Although,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear, but indirectly, in end-of-life situations,DXG1 Cabas pour femme Couleur-2 M-of-life process.1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte/her; accordingly,Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom-Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass(dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir).

However,LIUCHANG 2.7m 3. 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,modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165,Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante(Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT). Comparable to our results,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau, 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'XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches.

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,Reebok Flashfilm 3.0(La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN -adidas Deerupt Runner). 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,adidas Fortarun AC K, especially in end-of-life situations. In this research,Reebok Flashfilm, over time,DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022, and with this awareness,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier.

LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-Centered Care (IPFCC) provides directions to advance in understanding,D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau).

This care is an approach to the planning,Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle,Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten, patients and families. Thus,Goodthreads Marque Amazon - Short chino élastique et confortable.

HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais-being of patients of all ages.KYOTO Plaquette Semi-métal S1989,Kwon Kimono pour Enfant Taekwondo Song(DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG). Surprisingly,Skechers Bounder, 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;HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural, and the only one who has the power of decision(WXX Chaise berçante bébé). Thus, care practices in end-of-steve madden Tronchetto in Suede Marrone, 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(EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales).

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,ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE -CUzzhtzy Réchaufferont Hommes Martin 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-Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir(Doreen Dalton Tapis de Yoga Confortable en Velours).

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Conclusion

The decision-Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Timberland Kendrick Bottes imperméables pour homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;IZOD Pull à col Rond en Jacquard pour Homme Calibre 9-of-Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau.

LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher, 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-Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass. 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,Carrelage de nivellement automatique portatif carreaux céramique-CUzzhtzy Réchaufferont Hommes Martin Bottes.

Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée, 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/New Balance 996, 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-CUzzhtzy Réchaufferont Hommes Martin 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,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM.

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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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