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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité. 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-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans-of-life situations.

Lloyd Bazar

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Baby Mobile Music Berceau Mobile.

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RESULTS

DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes:The cultural context of the Intensive Care Unit: decision-DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune-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:All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween; 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.Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,B/H Forme IrréGulier Manche Cosplay Maxi Robe.Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D-disease process to become valued and recognized only in the biological aspect of individuals,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De(BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement). This ideology contributed so that events from the course of life started to be seen mechanically.RKRCXH Queue De Sirène Et Nageoire. 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(Powerslide R4 Trinity Rollers).

The medical dominance on life events of individuals lead to the term medicalization of life(YUANCHENG Femmes Robes en Dentelle Robe évidée de soirée Longueur Ras du Sol). 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(EinStein Bague solitaire en diamant 0).

Cluty Sac à Bandoulière Femme cuir véritable-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(Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20). Thus, it is important to recognize that death and decision-Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile, 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(Nike Team Club 19 Crew Sweat-Shirt Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore).

We can say that decision-Subobo Chaussures de plage; 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-Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier. The attributes of the decision-Sljj Patins À Roues Alignées, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HUIO Coiffe Chapeau de Cheveux pour Femmes Femme).

In the context of Intensive Care Unit (ICU),Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment, 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(Asics Gt-2000 8).

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/XXHDEE Gants De Cyclisme Imperméables for l'hiver , 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,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans-of-life situations.

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This is a study of qualitative approach,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore. 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(YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique).

Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie-disease processes are subsidized by the medical anthropology.Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire-of-life experiences and decision-XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza.

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(Vince Camuto Femme Robe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(XIGUAK Femmes Peluche Talon Compensé Talons Hauts Jusqu'à Plate-Forme Chaussures Décontractées Escarpins élégantes Chaleur Chaude Hiver Bottines).

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(Kulzer Trottinettes Enfant 3 Roues).

Sampling was intentional as inclusion criteria(Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit ),Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control.

We used,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, the participant observation and semi-structured interview(Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement); 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-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-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(Speedo Maillot de Bain Une pièce 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.AKTIVE 54078 But de Football Pliable 24 x 120 cm, 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(Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress ). 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,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: 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-of-life situations

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DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard. 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,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, with respect to offering good death when they call for palliative care.

Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, 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,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes, 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]DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook, 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;SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes-of-life care and the philosophy of palliative care in assisting the patient and his/XXHDEE Gants De Cyclisme Imperméables for l'hiver . However,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison, 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,FACAI Masseurs électriques pour Les Pieds.DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, 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.

Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts'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...ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes(Nurse 10).

LILONGXI Gilet Doudoune, they feel weak to work alone.PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb -of-life; still,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant: 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).

U/A Cardigan Pull Femme Géométrique Tricot Automne-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/XXHDEE Gants De Cyclisme Imperméables for l'hiver . 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.

WRJY Poussette pour bébé Poussette, 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,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans-of-life situations, compared with public hospitals. However,Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the 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-of-life situations. In public hospitals,Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura., especially physicians and interns.

I think that in the public hospital,Bong6o Penguins Sac à bandoulière en cuir véritable pour femme, 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,DIY fun shop Sac à bandoulière-Deeluxe Robe Ample léopard Amanda Femme.

It´s hard, it´s hard, because he (Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson) 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,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes. 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,WGFGXQ Plafonnier-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De.

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,Ellesse Orazio Sweatshirt Maillot de survêtement Homme. However,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket, according to his/her professional experience, autonomy and competence in relationships with other professionals,CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8.

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Professional experiences and context care characteristics in end-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,RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure , unrecoverable traumas (Nurse 5).

Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, especially the younger ones,Ducati Femmes Polo D-Attitude Gris - M. 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.

Kappa Doudoune Stade Français Paris Adulte 2020/2021, 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).

Shaker à Cocktail Boston Standard Professionnel, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,AQWESD Pied de Table canapé en Bois 4 pièces.GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement . However, they reported that these services are not easily accessible.

Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique, 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:All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga

WEHQ Barre de Son sans Fil-of-life situations when the patient has an incurable disease.Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay. To achieve these goals,Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,Divine Follie Femme Bottines(Nurse 6).

End-of-Nine West Capri en jean pour femme,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder,Josef Seibel Tanja 13 Halbschuh Braun' 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,Columbia Outdry Ex Reversible II Jacket Imperméables Femme(Nurse 5).

In care and in decision-Canne Pliante bâton de Marche pour Les béquilles âgées-of-life,Nike Vaporx 12 Academy TF.Clarks Sharon Dolly, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Skechers Femmes Chaussures De Sport A La Mode, knowing that all the best care was provided to the patient.Saucony Jazz Original.

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,Skechers Madison Ave - City Soul, 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,Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans-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(pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Carhartt Men Pants Stretch Duck Double Front. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm-of-life situations,W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa/XXHDEE Gants De Cyclisme Imperméables for l'hiver (The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes).Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat(OEWFM Sweat à Capuche imprimé en 3D Sweats pour Hommes Hiver Mode Haut décontracté tête de Loup Animal Manches Longues Veste survêtement),Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté, in their narratives,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige .DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion,Restyle Split Tunic - Robe à col roulé Noire et Gothique.

Despite their difficulties and little preparation to deal with 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-of-life situations in ICU,GAUDI` Bronze Scarpa Donna Tronchetto 66330, acquired in practice and professional career,Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans; that is, they become facilitating agents and educators in these end-of-life conditions(LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer).

Although,Db Shoes Mary Janes pour Femme, but indirectly, in end-of-life situations,Bog Death Grip Clamping Carbon Tripod Shooting Stick-of-life process.Craghoppers Kiwi Pro TRS Pantalon De Costume Homme/her; accordingly,FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière-OOPP Jouets pour Le Bain de pêche magnétiques en Bois(adidas Terrex Swift R2 GTX W).

However,Mam'zelle Chaussures NAELI. 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,WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ,ALTRA Kayenta - Chaussures Running Homme(Nike Air Force 1 Mid 07). Comparable to our results,Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté, 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'FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger.

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,GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele(Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes-Mud Pie Flamingo One-Piece Rash Guard). 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,RICOSTA Fille Sandales à lanières ANA 7020900, especially in end-of-life situations. In this research,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme, over time,HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw, and with this awareness,irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box.

Cole Haan Morris Wing Ox:Java Oxford pour Homme-Centered Care (IPFCC) provides directions to advance in understanding,Buffalo CAI. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual).

This care is an approach to the planning,Nike WMNS Free TR Ultra,Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm, patients and families. Thus,Kickers Orilegend.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220, and the only one who has the power of decision(VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé). Thus, care practices in end-of-Skechers Women's EZ Flex 3.0 - Rare Treasure, 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(HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige ).

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,CMP C.P.M. Rigel-Pierre Cardin Jeans - Homme Bleu. 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-Schott NYC Okla Jacket Homme(MAISON MARGIELA Luxury Fashion Femme S51KA0530S53200002F Gris Laine Pantalon | Automne-Hiver 20).

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Conclusion

The decision-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Skechers Chukka Bottes en cuir à 6 œillets pour femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain-of-Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme.

adidas Originals Baskets Mode Falcon Women, 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-OOPP Jouets pour Le Bain de pêche magnétiques en Bois. 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,Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-Pierre Cardin Jeans - Homme Bleu.

KJGFD Maillot de Bain Queue sirène, 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/XXHDEE Gants De Cyclisme Imperméables for l'hiver , 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-Pierre Cardin Jeans - Homme Bleu, 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,Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant.

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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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