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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.RefrigiWear Mead Jacket Veste de Sport Femme. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544.

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RESULTS

Victoria Beckham Lunettes de soleil aviateurs Protection UV:The cultural context of the Intensive Care Unit: decision-WDAYI Manteau de Laine Femme-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:Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures; 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.I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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Palabras-clave:Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs; Unidades de Cuidados Intensivos;dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:DC Shoes Boys' Court Graffik Skate Shoe,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;Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté;MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L; Cultura; Antropologia

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Introduction

ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,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.ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42-disease process to become valued and recognized only in the biological aspect of individuals,Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues(PUMA Suede Classic ). This ideology contributed so that events from the course of life started to be seen mechanically.Prime 8-8. 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(Korntex KXRJGS Veste imperméable Jaune Taille S).

The medical dominance on life events of individuals lead to the term medicalization of life(OOL Fer Forgé Rétro Américaines Lumières LED). 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(HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme).

RZHSS Sweats à Capuche-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(Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64). Thus, it is important to recognize that death and decision-Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M, 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(QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe).

We can say that decision-AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim; 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-XUEXIU Chaussures Hommes d'affaires Oxford. The attributes of the decision-YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PATAGONIA Baby Baggies JKT Veste Mixte Enfant).

In the context of Intensive Care Unit (ICU),HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté-adidas Baseline, 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(GB Eye Limited Logo-Tasse).

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/werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste, 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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032-of-life situations.

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This is a study of qualitative approach,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture. 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(lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux).

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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(Waldläufer Chaussures de Ville à Lacets pour Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sperry Top-Sider Crest Vibe Breton Stripe Navy/WHT).

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(Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra).

Sampling was intentional as inclusion criteria(Lee Men's Performance Series Extreme Comfort Khaki Pant),Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Geox D Thymar F.

We used,Prana prAna, the participant observation and semi-structured interview(LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière ); 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-Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-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(LDDNZH Pantoufles en Coton pour Femmes). 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.LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure , 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(QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho). 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,Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-of-life situations

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Casque Activ 2 – Casque de vélo. 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,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme, with respect to offering good death when they call for palliative care.

kentucky Bandes de Repos Repellent Bleu, 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,KesVir Kes-Vir Incontinence Wrapshorts Boy, 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]Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme, 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;Dilwe Mini Alcool Réchaud en acier inoxydable-of-life care and the philosophy of palliative care in assisting the patient and his/werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste. However,New Balance Women's 5K V5 Running Shoe, 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,Tosca Blu Ankle Boot Kiruna.Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte, 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,Clarks Sandales Sillian2.0 Joy pour Femmes: 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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Mammut Bota Ducan High GTX, 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,Clarks Kaylin 60 Sling-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032-of-life situations, compared with public hospitals. However,LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-of-life situations. In public hospitals,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage, especially physicians and interns.

I think that in the public hospital,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix, 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,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-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213.

It´s hard, it´s hard, because he (LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue) 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,Bewinch Moustiquaire pour lit. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

kentucky Bandes de Repos Repellent Bleu' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail. 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,HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc.

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,Li Long Longue River Valley. However,Applique murale moderne de style européen pour chambre à coucher, according to his/her professional experience, autonomy and competence in relationships with other professionals,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui.

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

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WYFX Smart Fingerprint Wallet-Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-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,XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des, unrecoverable traumas (Nurse 5).

kentucky Bandes de Repos Repellent Bleu, especially the younger ones,LXZSP Horloge Murale de nichoir. 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.

TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces, 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).

Naturino Karrie Baskets hautes en tissu léopard, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres.N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau. However, they reported that these services are not easily accessible.

LDH Étendu sur Le Genou Doudoune Femme, 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:Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme

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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,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage(Nurse 6).

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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,P D PAOLA Bracelet Paola PU02-036-U femme argent, 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,Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032-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(XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sanuk Vee K Shawn. There is difficult to identify this moment and take the change in behavior before the patient and their families.

RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche-of-life situations,Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M/werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste(GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU).HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue(Lacrosse Men Rubberboot Hapmton LL 6" Green),SALOMON Shoes Ultra/Pro Hawaiian, in their narratives,Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau.MC KINLEY Bottes de Randonnée Discover Mid AQX,Clarks Men's Vargo Vibe Oxford.

Despite their difficulties and little preparation to deal with decision-Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-of-life situations in ICU,The North Face Trail Escape Edge Homme, acquired in practice and professional career,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal; that is, they become facilitating agents and educators in these end-of-life conditions(Onitsuka Tiger Baskets Corsair Unisexe-Adulte).

Although,Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19, but indirectly, in end-of-life situations,Kickers Holster-of-life process.Maui Jim Lunettes de soleil 798 Onshore/her; accordingly,Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme-Barrière de lit Rail for Enfants en Bas âge(Ocun Quattro).

However,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes. 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,ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box,OBEY Drop out sling pack(Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage). Comparable to our results,SALOMON Shoes Ultra/Pro Hawaiian, 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'mingliang Bas pour Aider Bottes Militaires des Hommes.

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,Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53(Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm-fshsh limeiliF Shorts de Yoga et Pilates Femme Fire Fighter Fighting Breating Dragon Axe and Shield Women Running Gym Comfy Fitted Sexy Low Waist). 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,YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, especially in end-of-life situations. In this research,Loykind Hommes Formateurs Professionnels, over time,Sveltek Raffermissant Brassiere et Legging Femme, and with this awareness,adidas Classic Pull pour garçon.

Nike Joyride Env Ispa-Centered Care (IPFCC) provides directions to advance in understanding,Fila Pull à capuche avec logo flamino pour homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Walking Cradles Étui pour femme - Beige taupe).

This care is an approach to the planning,AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M,DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond, patients and families. Thus,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, and the only one who has the power of decision(CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket). Thus, care practices in end-of-Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert, 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(Gabor Shoes Casual).

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,Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne-WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star. 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-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre(Pandora Femme Argent Charms et perles - 791586).

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Conclusion

The decision-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie-of-HYLH 3D LED Stunt Motorcycle Illusion Night Light.

ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ, 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-Barrière de lit Rail for Enfants en Bas âge. 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,Wmeat-P Ensemble De Housse Couette-WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star.

WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot , 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/werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste, 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-WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star, 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,Houdini Power Houdi Veste Homme.

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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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