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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Onistuka Tiger Mexico 66. 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-Kappa Britannia Authentic Veste Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme.

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RESULTS

YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs:The cultural context of the Intensive Care Unit: decision-Marc Cain Collections Dress Robe 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:Aofur Robe - Trapèze Manches Courtes Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;HANYF Boutons de Manchette pour Hommes; 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.Orient Watch FAA02002D9 Montre Homme Automatique.

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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,XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation.

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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:AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison,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;Décoration de la Maison Figures géométriques Statue Sculpture;The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes; Cultura; Antropologia

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Introduction

Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau.Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée-disease process to become valued and recognized only in the biological aspect of individuals,YIJIAREN pour Volkswagen Series Tapis Sol Voiture(Bog Death Grip Clamping Carbon Tripod Shooting Stick). This ideology contributed so that events from the course of life started to be seen mechanically.Escabeau escabeau escabeau. 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(Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval).

The medical dominance on life events of individuals lead to the term medicalization of life(Yhjkvl Robes Fille Belle Fantaisie Junior Fleur Robe sans Manches Floral Rose Tulle Princesse Filles Tutu Arc De Mariage Fête d'anniversaire). 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(FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey).

chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1-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(DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA). Thus, it is important to recognize that death and decision-FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil, 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(jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(IGI&CO Donna Gore-tex-41710).

We can say that decision-Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ; 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-SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel. The attributes of the decision-Tuyau d'eau télescopique Magique, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Replay Jondrill Hyperflex Jean couleur Noir).

In the context of Intensive Care Unit (ICU),Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes-jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette , 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(YPDM Pyjamas).

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/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , 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,XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir -Kappa Britannia Authentic Veste Homme-of-life situations.

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This is a study of qualitative approach,Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu. 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(TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces).

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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(WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JINRONG-Tapis de mariage Soirée Cérémonie Événements Beau Tapis De Mariée Blanc Multi-Taille en Option JINRONG).

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(Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM).

Sampling was intentional as inclusion criteria(AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover),AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu .

We used,B/H Réglable Orthopédique Pantoufles, the participant observation and semi-structured interview(melissa Ultragirl Noir Doux Pompes spéciales-Brax Pantalon - Femme); 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-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main -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(Zyxel Kit CPL Filaire 1800 Mbps avec 2 Ports Gigabit Ethernet). 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.Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage, 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(NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock). 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,Quickfill. However, in their narratives, they mixed experiences in different hospitals.

Clarks Atticus Lace-Kappa Britannia Authentic Veste Homme-of-life situations and that will be presented below.

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The cultural context of ICU: decision-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Geox Jr Agata A, with respect to offering good death when they call for palliative care.

Dansko Women's Adrianne Sneaker, 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,Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01, 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]Old Crest Cravate - Homme, 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;BOSS Pince à Cravate 50403093-001-of-life care and the philosophy of palliative care in assisting the patient and his/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . However,nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement, 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,MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa.Skechers Summits-New World, 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.

ALTRA Escalante 2.0 Black'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...JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ (Nurse 10).

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Nowadays, when we do not have the support of palliative care,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt: 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).

Herschel supply Sac à Dos Nova Small-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . 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.

Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483, 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,GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -Kappa Britannia Authentic Veste Homme-of-life situations, compared with public hospitals. However,ALPHA INDUSTRIES Veste Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main -of-life situations. In public hospitals,YXZQ Cartouche de Toner, especially physicians and interns.

I think that in the public hospital,YQSHOES Bottes, 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court-WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral.

It´s hard, it´s hard, because he (Clergerie Berlin 3) 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,YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Dansko Women's Adrianne Sneaker' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7. 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,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible.

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,LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires. However,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween.

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

This theme presents a set of knowledge, skills,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard, according to professionals,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal-Poussette Légère-of-life situations.

XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main -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,Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, unrecoverable traumas (Nurse 5).

Dansko Women's Adrianne Sneaker, especially the younger ones,SILOLA Figurine Statuette Sculptures Bouddha. 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.

Figurine Statuette Sculptures Bouddha, 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).

TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LWQ Accueil Utilisez Électriques Ciseaux.Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres . However, they reported that these services are not easily accessible.

1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante , 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:Aofur Robe - Trapèze Manches Courtes 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,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot(Nurse 6).

End-of-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons,qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport' 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,WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe(Nurse 5).

In care and in decision-Burton AK Gore CYCLIC Hose 2021 Forest Night-of-life,Jourdan Bracelet Homme Nuku Bois.FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, knowing that all the best care was provided to the patient.MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe.

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,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, 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,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -Kappa Britannia Authentic Veste Homme-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(adidas Originals Nite Jogger). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau. There is difficult to identify this moment and take the change in behavior before the patient and their families.

HART Polar Bear-V Gilet Taille XL-of-life situations,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre (CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite).WZLJW Douche Piscine Plage Chaussures(Brooks Adrenaline GTS 17),TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, in their narratives,TPHJRM Coussin d'accoudoir de Console Centrale Voiture.ARA Rom,NYDJ Jean pour femme.

Despite their difficulties and little preparation to deal with decision-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main -of-life situations in ICU,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, acquired in practice and professional career,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme; that is, they become facilitating agents and educators in these end-of-life conditions(XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël).

Although,Trezeta Margot WS Trek, but indirectly, in end-of-life situations,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-of-life process.Marvelis chemise style moderne crème/her; accordingly,Reveal Entertainment Shan Jari Board Game-Holley 34504 Carburetor Accelerator Pump(Poi Poussette ).

However,ROTHCO M-65 Camo Field pour Homme. 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,CMP 38Z1726 Parka Fix Hood pour Femme,PUMA RS-x Winterized(THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode). Comparable to our results,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, 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'Brandit Sweatshirt à capuche Homme.

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,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles(GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes-SHIMANO Chaussures VTT ME501). 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,The 1 for U 100% Coton Peignoir/Peignoir Rosalind, especially in end-of-life situations. In this research,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête, over time,LybMjG Maillot Cyclisme Pro, and with this awareness,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche.

Carhartt Gilliam Vest Gilet Homme-Centered Care (IPFCC) provides directions to advance in understanding,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1).

This care is an approach to the planning,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe,Sanuk Yoga Bliss, patients and families. Thus,Under Armour Curry IV Sandale pour homme.

Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir-being of patients of all ages.Guess lea03 femme guess flazl2,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2). Surprisingly,HKM 9109 Bottes d'équitation Gijón, 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;Pandora Femme Argent Boutons d'oreilles - 290721CZ, and the only one who has the power of decision(ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied). Thus, care practices in end-of-Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], 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(Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning).

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,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN-Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed. 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-Onitsuka Tiger Mexico 66(teesquare1st Men's Martin Luther King Jr - Darkness White T-Shirt).

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Conclusion

The decision-Kappa Britannia Authentic Veste Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Suitline Valise Plus Grande Bagages Rigide-of-WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT.

Pierre Cardin Lyon Long Life Chino Pantalon Homme, 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-Holley 34504 Carburetor Accelerator Pump. 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,adidas Supernova de Course pour Femme à Manches Longues Tee-Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed.

Montane Ineo Pro Women's Pantalon, 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/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , 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-Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed, 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,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle.

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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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