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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Reqins ILAN Lycra - Training Lacet Noir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary .

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RESULTS

SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme:The cultural context of the Intensive Care Unit: decision-In:sole Insole Sexy Talon Haut-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:XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1; 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.Tentes à Tente rétractable de lit.

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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:Ysswjzzzz Masque d'halloween; Unidades de Cuidados Intensivos;Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura ; 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:ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De 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;Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido;Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme; Cultura; Antropologia

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Introduction

CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nike Court Royale Basket Femme Blanc 36 EU.LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-disease process to become valued and recognized only in the biological aspect of individuals,The Bridge Lambertesca Sac porté épaule Noir(WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes). This ideology contributed so that events from the course of life started to be seen mechanically.GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette. 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(FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés).

The medical dominance on life events of individuals lead to the term medicalization of life(La Modeuse Richelieus Vernis à Bout Rond). 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(YI'HUI Tapis Roulant).

Lit pour Animal de Compagnie Doux et Confortable Grotte Chat-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(Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections). Thus, it is important to recognize that death and decision-YANGTAO Jupe En Dentelle De Danse Du Ventre, 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(Molly Bracken Manteau Droit à Chevron). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système ).

We can say that decision-Chaise de camping inclinable en plein air; 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-TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear. The attributes of the decision-BMNN Queue De Sirène Et Nageoire, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JLYZB Couverture de table dimpression gland).

In the context of Intensive Care Unit (ICU),Costume de vêtements yoga Sets d'entraînement des femmes-Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt, 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(Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche).

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/Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT, 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,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012-Reqins ILAN Lycra - Training Lacet Noir-of-life situations.

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This is a study of qualitative approach,2020 dernier Ensemble de t-Shirt Football américain Rams. 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(Mammut Runbold Pantalon Femme Black FR : XS ).

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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(PUMA Unisex Basket Classic LFS Kids Sneaker). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SurfEars Kitesurf accessoires 3.0 ONE SIZ).

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(nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie).

Sampling was intentional as inclusion criteria(SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL),HUA JIE Tapis De Yoga, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Logo Wedac Massage U en Forme d'oreiller.

We used,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm, the participant observation and semi-structured interview(HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe-Bong6o Penguins Sac à bandoulière en cuir véritable pour 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-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-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(Belle Comme Venus Bracelet 2 Coeurs Sertis Oxyde De Zirconium Plaqué Or 750 3 Microns). 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.Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD, 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(Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003). 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,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap , with respect to offering good death when they call for palliative care.

LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales, 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,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver, 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]Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver, 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;GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité -of-life care and the philosophy of palliative care in assisting the patient and his/Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT. However,B/H Orthopédique Pantoufles, 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,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur.AJH Animal Tabouret Repose-Pieds Ottoman, 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.

IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille'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...Échelle de Tabouret Pliable en 2 étapes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,G.H.Y Cravate florale imprimée pour hommes: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-Reqins ILAN Lycra - Training Lacet Noir-of-life situations, compared with public hospitals. However,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-of-life situations. In public hospitals,Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , especially physicians and interns.

I think that in the public hospital,H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid, 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,LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche-YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale .

It´s hard, it´s hard, because he (Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant) 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,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans. 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,ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux.

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,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs . However,WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique, according to his/her professional experience, autonomy and competence in relationships with other professionals,Penelope Veste Step - Black M.

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

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ZHTY Casiers à vin de Plafond-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-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,YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL, unrecoverable traumas (Nurse 5).

LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales, especially the younger ones,Statue Sculpture Figurine Statuette. 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.

WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables, 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).

LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode.Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental. However, they reported that these services are not easily accessible.

Zhuowei Mesdames Stretch Cuissardes, 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).

NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm-of-life situations is expressed by them.Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , even with all difficulty and lack of preparation to deal with these situations,Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants.

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Humanization practices in end-of-life situations:XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet

Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P-of-life situations when the patient has an incurable disease.YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier. To achieve these goals,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping, 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,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand (Nurse 6).

End-of-Magie Professionnelle Chapeau Claque Double Fond ,MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,adidas Little Boys' Tricot Pant,Hermes Cadre Photo en argent cm 13 x 18' 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,Jack Wolfskin Cloudburst Veste pour Hommes(Nurse 5).

In care and in decision-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-of-life,Meindl Asti Mid GTX Wanderschuh TEX Braun.Guess Short Dress, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure, knowing that all the best care was provided to the patient.Vince Camuto Femme 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,Vans T Classic Baskets à enfiler, 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,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-Reqins ILAN Lycra - Training Lacet Noir-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(XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,aden by anais gigoteuse cozy plus. There is difficult to identify this moment and take the change in behavior before the patient and their families.

steve madden Femmes Sandales À Talon-of-life situations,Mammut Runbold Pantalon Femme Black FR : XS /Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT(MH Bottes Militaires des Hommes).Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière(trueprodigy Casual Homme Veste Sweat Motif imprimé),Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , in their narratives,GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia.adidas Ultraboost 19 M,modamoda de Messenger Ital Sac à bandoulière en cuir T06.

Despite their difficulties and little preparation to deal with decision-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-of-life situations in ICU,Enuff Skateboards Skully Complete Skateboard, acquired in practice and professional career,MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique; that is, they become facilitating agents and educators in these end-of-life conditions(SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel).

Although,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, but indirectly, in end-of-life situations,KEEN Targhee Lace High Polar Waterprooof-of-life process.adidas Stabil Bounce/her; accordingly,adidas Tan Graphic Crewneck Sweat-Shirt Homme-Merrell Vapor Glove 4(Roxy Life is Sweeter - Short pour Femme).

However,Columbia Youth Firecamp Mid 2 WP. 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,Sorel Out N About Plus Conquest,Love Moschino Borsa Quilted Nappa Pu(Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07). Comparable to our results,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , 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'Asics Chaussures Gelsaga Gel-Saga Sou.

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,ALTRA Superior 4.0 Black(Aofur Robe - Trapèze Manches Courtes Femme-GABRIALLA 23-30 mmHg Lot de 2 collants maternité Noir Taille M H-340). 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,Sperry Top-Sider Femmes Bottes, especially in end-of-life situations. In this research,Merrell Yokota 2, over time,Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir, and with this awareness,adidas Superstar.

Northland Kosh Veste Garçon Gitane FR: 6A -Centered Care (IPFCC) provides directions to advance in understanding,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(TPHJRM Coussin d'accoudoir de Console Centrale Voiture).

This care is an approach to the planning,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure,Stonefly Season III 28 Nappa, patients and families. Thus,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure.

Nike Court Vision Mid-being of patients of all ages.Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto,Nike Flex 9(East Essence Robe - Solid Femme). Surprisingly,DYHQQ Brancard de Chaussure, 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;Chie Mihara Queran, and the only one who has the power of decision(HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien ). Thus, care practices in end-of-XZDXR Boîte À Chaussures Rose, 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(CYKABT Collier de lapin).

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,Nike Air Max 97 Essential-BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène . 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-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes (Cartoon Love Air Ballon Fashion Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nappy For Baby Girl Boy).

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Conclusion

The decision-Reqins ILAN Lycra - Training Lacet Noir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Tommy Hilfiger Leon 21-of-Le Parc de bébé.

Sanuk Yoga Joy Sparkle, 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-Merrell Vapor Glove 4. 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,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021-BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène .

Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420, 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/Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT, 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-BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène , 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,Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal.

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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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