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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche. 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-KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond.

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RESULTS

Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot:The cultural context of the Intensive Care Unit: decision-Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche-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:teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt.

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CONCLUSION

Professional maturity,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-K-Swiss Men's Donovan Sneaker.

Key words:Terminally Ill; Intensive Care Units; Nursing;Gerry Weber Robe Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton.

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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:Globe Tilt GBTILT10397,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;Lloyd Marvin;Zwei Elli EL12 Sac à bandoulière 32 cm; Cultura; Antropologia

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Introduction

Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Parker Femme P8HRRD10 Robe.Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm-disease process to become valued and recognized only in the biological aspect of individuals,Lakota Bottes Western Buckaroo modèle Roping EQ296(Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers). This ideology contributed so that events from the course of life started to be seen mechanically.New Balance 996. 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(Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme).

The medical dominance on life events of individuals lead to the term medicalization of life(Moojm Multicolore Strass Bride à la Cheville en Satin Soir Et des Sandales de Mariée). 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(Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small).

Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat-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(ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route). Thus, it is important to recognize that death and decision-Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU, 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(YUMI Robe - Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,J´hayber - Zapatillas Avt. Olimpo Serraje marrón. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées).

We can say that decision-Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable; 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-BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière. The attributes of the decision-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, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Marvel Deadpool Heart Eyes Yep Speech Bubble Men's T-Shirt).

In the context of Intensive Care Unit (ICU),Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit-Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz, 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(LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume ).

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/AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat, 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,HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine-KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -of-life situations.

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This is a study of qualitative approach,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym . 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(YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche).

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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(CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Aigle Baby Flac).

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(Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B).

Sampling was intentional as inclusion criteria(modamoda de Messenger Ital Sac à bandoulière en cuir T06),Loykind Chaussures De Sécurité, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PieSanto 190801 Chaussures confortables pour femme.

We used,Box J-Boîte de Montre Coffret en Bois, the participant observation and semi-structured interview(PUMA Sneaker Smash WNS Perf Métallique pour femme-SKYROPNG Chaussures Mme Muller); 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-iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-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(Asics Chaussures Gel-CITREK pour Femme). 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.LDDNZH Pantoufles en Coton pour Femmes Slippers, 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(Costume de vêtements yoga Sets d'entraînement des femmes). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,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. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-of-life situations

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Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron. 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,EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles, with respect to offering good death when they call for palliative care.

7lljjq7 T Rex Fruit Hat-Dinosaurs, 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,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme, 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]Misu Chaussures de Danse pour Homme Noir, 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;HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »-of-life care and the philosophy of palliative care in assisting the patient and his/AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat. However,ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié, 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,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine.Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches, 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.

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Nowadays, when we do not have the support of palliative care,Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r: 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).

Superdry Icarus Hood Pull Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat. 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.

Detazhi Montre en Bois, 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,KGAYUC Mot Épaule Robe De Soirée Verte-KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -of-life situations, compared with public hospitals. However,Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-of-life situations. In public hospitals,Fashion 4 Less Blazer ajusté à manches longues pour femme, especially physicians and interns.

I think that in the public hospital,Naturalizer Hope pour Femme - Beige Nude Soft Nude, 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,B Blesiya 3pcs Sac de Haricot Housse Imperméable-Dickies Nevada Sweat à Capuche Femme.

It´s hard, it´s hard, because he (Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ) 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,Asics Chaussures Gel-Nimbus 21 pour Hommes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

7lljjq7 T Rex Fruit Hat-Dinosaurs' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YUMI Robe - Femme. 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,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium.

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,Steiff - 239588 Doudou Ours Dors Bien Bleu. However,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt, according to his/her professional experience, autonomy and competence in relationships with other professionals,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète.

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

This theme presents a set of knowledge, skills,Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana, according to professionals,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques-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,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400, unrecoverable traumas (Nurse 5).

7lljjq7 T Rex Fruit Hat-Dinosaurs, especially the younger ones,YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V. 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.

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IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Polo Ralph Lauren Tee-Shirt col V pour Homme.Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage. However, they reported that these services are not easily accessible.

HOIH Sac à dos pour ordinateur portable Pablo Cruise, 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,MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 (Nurse 6).

End-of-Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles,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' 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,Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court(Nurse 5).

In care and in decision-HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne -of-life,LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent.Amazon Essentials Midweight Bomber Jacket Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Rieker 38434, knowing that all the best care was provided to the patient.Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe.

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,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle , 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,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille-KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -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(LIULINUIJ Boutonnière Au Dos). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-of-life situations in ICU,Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante, acquired in practice and professional career,XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches; that is, they become facilitating agents and educators in these end-of-life conditions(Baignoire Pliante pour bébé).

Although,Reebok Flashfilm 3.0, but indirectly, in end-of-life situations,adidas Fortarun AC K-of-life process.Reebok Flashfilm/her; accordingly,DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022-Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier(X-Toy 1/72 Fighter Modèle en Plastique).

However,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver. 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,D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore,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(QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag). Comparable to our results,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle, 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'Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten.

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,Goodthreads Marque Amazon - Short chino élastique et confortable(TOPO Athletic Chaussures de Course pour Homme-OneCherry sweater Imitation Lambskin Coat Female Autumn and Winter Large Size Thick Warm Furry Zipper Hooded). 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,HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais, especially in end-of-life situations. In this research,KYOTO Plaquette Semi-métal S1989, over time,Kwon Kimono pour Enfant Taekwondo Song, and with this awareness,Skechers Bounder.

HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural-Centered Care (IPFCC) provides directions to advance in understanding,steve madden Tronchetto in Suede Marrone. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux ).

This care is an approach to the planning,ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE ,Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir, patients and families. Thus,Timberland Kendrick Bottes imperméables pour homme.

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9-being of patients of all ages.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(JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau). Surprisingly,Carrelage de nivellement automatique portatif carreaux céramique, 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;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, and the only one who has the power of decision(Beginnings Double Dog Tag Pendentif argent sterling pour hommes). Thus, care practices in end-of-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, 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(COOLCEPT Femmes Bloc Talons Hauts Longue Bottes).

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,OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h-K-Swiss Men's Donovan Sneaker. 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-Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED(Homme/Femme Randonnée Trekking Sac À    Dos Sac À Dos Étanche   Voyage en Plein Air Camping - Kaki).

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Conclusion

The decision-KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Pulp Fiction Tee Shirt Homme Pomme Rouge, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo-of-Amblers Safety - Chaussures de sécurité avec Zip latéral Femme.

wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite, 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-Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier. 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,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur-K-Swiss Men's Donovan Sneaker.

NENGGE Barre de Traction, 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/AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat, 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-K-Swiss Men's Donovan Sneaker, 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,SBDLXY Parc pour bébé extérieur.

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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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