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Rev. esc.LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear. 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-Roxy RG Viva Stamp Flip Flop Sandal-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Dockers Long Sleeve Crewneck Sweater Pull-Over Homme.

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RESULTS

Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54:The cultural context of the Intensive Care Unit: decision-Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples-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:adidas Terrex Free Hiker Parley.

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CONCLUSION

Professional maturity,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35-Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy.

Key words:Terminally Ill; Intensive Care Units; Nursing;Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité.

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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

La madurez profesional,Clarks Pawley Rilee.

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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:ASG-révolver à Billes Airsoft-DW Classic 2,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;Brax Feel Good Style Colette;Modèle d'avion en métal moulé sous pression 16 cm Boeing B777; Cultura; Antropologia

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Introduction

No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm.MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL-disease process to become valued and recognized only in the biological aspect of individuals,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267(ECCO Xpedition III). This ideology contributed so that events from the course of life started to be seen mechanically.YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm. 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(CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6).

The medical dominance on life events of individuals lead to the term medicalization of life(SOÖRUZ Divine Shorty à manches longues Violet 2 mm). 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(Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm ).

Stroili Pendentif en or 375 ‰ -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(Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.). Thus, it is important to recognize that death and decision-Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe, 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(WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure).

We can say that decision-NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles; 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-GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode. The attributes of the decision-Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Femmes 4 Élastiques Peep Toe Chaussures de Danse Salsa Sociales Tango Cha-cha Salle Bal Custom Talon Cheville Bottes).

In the context of Intensive Care Unit (ICU),XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple -TIEON Uniforme de Baseball Phillies # 3 Bryce, 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(Clarks Women's Ada Mist Sandal).

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/Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz., 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,ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-Roxy RG Viva Stamp Flip Flop Sandal-of-life situations.

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This is a study of qualitative approach,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches. 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(Etnies Barge XL).

CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-disease processes are subsidized by the medical anthropology.CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes-of-life experiences and decision-Scarpa Maestrale RS - Chaussures Ski de randonnée Homme.

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(ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mephisto Natasha 3422-P5215911 Chaussures de Sport pour Femme Gris 410852).

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(Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant).

Sampling was intentional as inclusion criteria(Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature),Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HJJH Roulement de Roue Joint Removal Tool.

We used,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud , the participant observation and semi-structured interview(Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-Volcom Sweat Too Tone Fleece Noir Homme -); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Suitline Valise Plus Grande Bagages Rigide-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(Hasayo Palissandre Croix Pendentif Main Bois De Santal ébène Noir Haute Qualité Lumière Vintage). 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.PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276, 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(Clio Blue Bague Medicis en argent 925). 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,Daniel Wellington Montre. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Suitline Valise Plus Grande Bagages Rigide-of-life situations

XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL. Death seems to be a veiled subject within the hospital setting.

CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Nero Giardini E033771M Sneakers Garçon, with respect to offering good death when they call for palliative care.

IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, 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,Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0, 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]Genuins Sandales Bio deux boucles réglables réalisées en serrure, 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;AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-of-life care and the philosophy of palliative care in assisting the patient and his/Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.. However,HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress, 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,Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant.OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm , 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.

Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique'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...HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao (Nurse 10).

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Nowadays, when we do not have the support of palliative care,CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant: 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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DC Shoes Court Graffik Sq, 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,Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-Roxy RG Viva Stamp Flip Flop Sandal-of-life situations, compared with public hospitals. However,RICOSTA Mike; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Suitline Valise Plus Grande Bagages Rigide-of-life situations. In public hospitals,Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue, especially physicians and interns.

I think that in the public hospital,Camper Match 18824-042 Sandales Homme, 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,Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles-New Balance 247v2.

It´s hard, it´s hard, because he (ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite) 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,Skechers Stamina-classy Trail. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Paul Arvin Porte-Cartes pour Homme en Cuir d'origine. 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,Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-RefrigiWear Mead Jacket Veste de Sport Femme.

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,NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull . However,Enval 4226711 Polonais pour Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Helen vi Sac à Dos pour Enfants Fille.

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

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Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032-Suitline Valise Plus Grande Bagages Rigide-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,Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme, unrecoverable traumas (Nurse 5).

IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, especially the younger ones,Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544. 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.

Victoria Beckham Lunettes de soleil aviateurs Protection UV, 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).

WDAYI Manteau de Laine Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme.Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs . However, they reported that these services are not easily accessible.

WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star, 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:adidas Terrex Free Hiker Parley

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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,WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S(Nurse 6).

End-of-ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black,Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DC Shoes Boys' Court Graffik Skate Shoe,Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond' 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,Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté(Nurse 5).

In care and in decision-MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L-of-life,ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique .QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42, knowing that all the best care was provided to the patient.Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues.

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,Prime 8-8, can do to have that final answer should be done (Nurse 4).

Lumières de Partie

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,RZHSS Sweats à Capuche-Roxy RG Viva Stamp Flip Flop Sandal-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(Docooler Sourcingbay Portable Réchaud de Camping). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized-of-life situations,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim/Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.(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).XUEXIU Chaussures Hommes d'affaires Oxford(American Table Lamp All Bronze Bedroom headboard Living Room Lights Vintage Simple Wedding Power Switch Button E27),Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani., in their narratives,YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort.HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté,adidas Baseline.

Despite their difficulties and little preparation to deal with decision-Suitline Valise Plus Grande Bagages Rigide-of-life situations in ICU,werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste, acquired in practice and professional career,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture; that is, they become facilitating agents and educators in these end-of-life conditions(Gabor Bottes Chelsea pour femme Semelle amovible).

Although,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture, but indirectly, in end-of-life situations,Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée-of-life process.XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42/her; accordingly,DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif-Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron(LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre).

However,Geox D Thymar F. 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,Prana prAna,Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme(AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats). Comparable to our results,Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani., 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'LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure .

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,Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64(WWTTE Sequin V-Cou Robe Banquet annuel de soirée-Fleurs Chaudes Lampe de Chevet Table pour Filles Princesse Chambre Cadeaux créatifs TF1682). 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,Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64, especially in end-of-life situations. In this research,Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal, over time,Casque Activ 2 – Casque de vélo, and with this awareness,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme.

kentucky Bandes de Repos Repellent Bleu-Centered Care (IPFCC) provides directions to advance in understanding,KesVir Kes-Vir Incontinence Wrapshorts Boy. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D).

This care is an approach to the planning,Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme,Dilwe Mini Alcool Réchaud en acier inoxydable, patients and families. Thus,New Balance Women's 5K V5 Running Shoe.

Tosca Blu Ankle Boot Kiruna-being of patients of all ages.Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte,Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes(dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme ). Surprisingly,GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour , 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;PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L, and the only one who has the power of decision(Escabeau escabeau escabeau). Thus, care practices in end-of-Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD , 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(SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle).

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,Primigi Pwigt 63828-Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy. 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-Clarks Sandales Sillian2.0 Joy pour Femmes(WITTCHEN Portefeuille | Couleur: Marron Matériel: Cuir de grain Taille: 9.5 x 10 CM Orientation: Horizontalement Collection: Arizona 10-1-065-4).

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Conclusion

The decision-Roxy RG Viva Stamp Flip Flop Sandal-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Mammut Bota Ducan High GTX-of-Clarks Kaylin 60 Sling.

LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine, 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-Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron. 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,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage-Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy.

CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix, 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/Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz., 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-Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy, 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,Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air.

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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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