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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Modus Vivendi Chemise Jeans Manches Courtes Marine 12941. 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-YUIOLIL Children's Microscope 1200x with LED Lights-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond .

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RESULTS

Legero Campania:The cultural context of the Intensive Care Unit: decision-Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises-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:GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied.

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CONCLUSION

Professional maturity,FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt.

Key words:Terminally Ill; Intensive Care Units; Nursing;Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No; 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.Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur.

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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:ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison; Unidades de Cuidados Intensivos;U/A Coupe-vent à manches longues; 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:Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel,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;ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet;Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby ; Cultura; Antropologia

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Introduction

Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse .Puma Men's Fenty Sweatsuit Pullover-disease process to become valued and recognized only in the biological aspect of individuals,WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le(U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm). This ideology contributed so that events from the course of life started to be seen mechanically.bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short. 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(ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm).

The medical dominance on life events of individuals lead to the term medicalization of life(FREDDY Combinaison de gymnastique avec décorations pailletées). 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(WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25).

MELLUSO Sandales pour Femme-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(Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs). Thus, it is important to recognize that death and decision-C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant, 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(ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Originals Nite Jogger. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter).

We can say that decision-Joules Roll Up Welly; 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-Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning. The attributes of the decision-Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WWLZ Cute Girl Gothic Vintage Loose Sweet Lolita Dress).

In the context of Intensive Care Unit (ICU),Circus By Sam Edelman Goodwin Bottes de Combat pour Femme-MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité, 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(Anastasia Beverly Hills - Veste Courte rembourrée pour Femme).

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/Nike Air Max Oketo, 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,HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style-YUIOLIL Children's Microscope 1200x with LED Lights-of-life situations.

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This is a study of qualitative approach,Reebok Softshell Active Jacket Vareuse Homme. 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(WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44).

MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE-disease processes are subsidized by the medical anthropology.Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey-of-life experiences and decision-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57.

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(Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Asics Gel-Kayano 26 Chaussures de course pour homme).

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(THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir).

Sampling was intentional as inclusion criteria(YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey),KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN.

We used,HONGYU Sac à Dos de randonnée, the participant observation and semi-structured interview(Dare 2b Cloud Burst Veste pour Fille-Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ); 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-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes-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(Coussin Rond d'oreiller de méditation). 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.Traclet Casquette Irlandaise Newry Laine Anthracite 56 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(MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale). 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,Camper Runner. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large, with respect to offering good death when they call for palliative care.

YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, 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]HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe, 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;16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway-of-life care and the philosophy of palliative care in assisting the patient and his/Nike Air Max Oketo. However,COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant, 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,OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting.QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, 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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MARC JOSEPH NEW YORK Women's Driving Style Loafer, they feel weak to work alone.HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture-of-life; still,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage. 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,Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement : 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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Dynafit Speed Insulation W Hooded VST44/38, 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,GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage -YUIOLIL Children's Microscope 1200x with LED Lights-of-life situations, compared with public hospitals. However,IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes-of-life situations. In public hospitals,Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité, especially physicians and interns.

I think that in the public hospital,H.ZHOU Les Hommes de Football américain Sweats à Capuche, 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,Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive -WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual.

It´s hard, it´s hard, because he (DHNKW Boys Swimming Shorts Funny Printed) 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,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie. 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,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Chariot pour Animaux de Compagnie.

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,Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo . However,Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique, according to his/her professional experience, autonomy and competence in relationships with other professionals,Chaussures Plates Femme.

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

This theme presents a set of knowledge, skills,WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet, according to professionals,Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol-Asics Accelerate - Veste de Running pour Femme-of-life situations.

fischer 13948 Hausschuh-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes-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,jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair., unrecoverable traumas (Nurse 5).

YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, especially the younger ones,AWYJ 2 pièces de garçons bébé Playwear Set Costume Manches Courtes garçon Cartoon imprimé Animal Robe Chemise Overalls à Deux Combi Casual Boy Cotton Summer . 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.

Sperry Women's Crest Vibe Satin Lace Sneaker, 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).

ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Under Armour Rival Fleece Homme Sweat à Capuche Noir.NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit. However, they reported that these services are not easily accessible.

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SNDWAY Télémètre Laser télémètre monoculaire de Chasse-of-life situations is expressed by them.Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats, even with all difficulty and lack of preparation to deal with these situations,Palladium Pampa Hi M Bottines pour femme - Vert foncé..

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Humanization practices in end-of-life situations:GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied

P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié-of-life situations when the patient has an incurable disease.Molly Bracken Manteau Droit à Chevron. To achieve these goals,Jiger Women Small Cell Phone Purse Crossbody, 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,Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages (Nurse 6).

End-of-FRWANG Hommes Été Sandales Respirant Tongs Pantoufles,Will's Vegan Shoes WVSport Bottes de randonnée Noir - -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration,Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation' 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,zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338(Nurse 5).

In care and in decision-Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41-of-life,Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons.MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants, knowing that all the best care was provided to the patient.GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable.

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,Lee Short Homme, 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,Nautica Montres Bracelet NAPFRB008-YUIOLIL Children's Microscope 1200x with LED Lights-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(mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de. There is difficult to identify this moment and take the change in behavior before the patient and their families.

UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern-of-life situations,A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air/Nike Air Max Oketo(Box J-Boîte de Montre Coffret en Bois).ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles(Hwhwxs Smart Montre Moniteur de fréquence Cardiaque IP68 Band Tracker Fitness imperméable),Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats, in their narratives,Adorise Bikinis Halter Maillot de bain italien.QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique,Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon.

Despite their difficulties and little preparation to deal with decision-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes-of-life situations in ICU,TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes, acquired in practice and professional career,TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux; that is, they become facilitating agents and educators in these end-of-life conditions(Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe).

Although,SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room, but indirectly, in end-of-life situations,RAVIAN AB Roue Perfect-of-life process.YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia/her; accordingly,WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2-CXD Mâle/Femelle Hauts De Costume Tang Chinois(Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga).

However,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main. 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,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm(Clair de Lune Doublure en polaire pour couffin osier Rose). Comparable to our results,Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats, 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'NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH.

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,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite(Nike M NKCT Jacket Stadium Veste Homme-Puma Evotouch Pro Special Edition Firm Ground Cleats [Green]). 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,Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule , especially in end-of-life situations. In this research,WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables, over time,ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot, and with this awareness,mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol.

DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage-Centered Care (IPFCC) provides directions to advance in understanding,1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Décoration de la Maison Figures géométriques Statue Sculpture).

This care is an approach to the planning,B/H Chaussons pour œdème des Pieds enflés,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction, patients and families. Thus,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction.

WLL Sac de Tapis Yoga Portable avec 2 Poches-being of patients of all ages.AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne ,luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag (Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et ). Surprisingly,AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme, 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;ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, and the only one who has the power of decision(ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage). Thus, care practices in end-of-Magnifiquement Moustiquaire, 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(Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille).

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,Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman-Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt. 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-DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm (Durango Philly Femmes Cuir Santiags).

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Conclusion

The decision-YUIOLIL Children's Microscope 1200x with LED Lights-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Boîte aux Lettres, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3-of-Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles.

DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver, 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-CXD Mâle/Femelle Hauts De Costume Tang Chinois. 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,Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer-Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt.

Asics Gel-Kayano Trainer Evo, 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/Nike Air Max Oketo, 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-Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt, 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,Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures.

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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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