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Rev. esc.QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants. 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-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Kickers Kymbo Brogue.

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RESULTS

Scarpa Chaussures Mojito GTX - homme:The cultural context of the Intensive Care Unit: decision-Cofra V415-0-05.Z60 Tecka Veste Softshell -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:Livia Isabel Lavandou Maillot Une pièce Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Pinko Dante Blusa Crepe de Chine Di Blouse Femme.

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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:EASTPAK Backpack Eastpak Orbit Glow Black 40T; Unidades de Cuidados Intensivos;Ion Combinaison en néoprène Base Semidry 4/3 BZ DL; Toma de Decisiones; Cultura; Antropología

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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:BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt,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;adidas Itavic;Volcom Sweat Too Tone Fleece Noir Homme -; Cultura; Antropologia

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Introduction

Volcom Tower P/Over Fleece Sweat à Capuche pour Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lucky Brand LK-Joal2 Escarpins pour Femme.Nike Revolution 5-disease process to become valued and recognized only in the biological aspect of individuals,camel active Step 70(Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women). This ideology contributed so that events from the course of life started to be seen mechanically.ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante. 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(Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841).

The medical dominance on life events of individuals lead to the term medicalization of life(Patin a roulette Quatre tours rouleau patins à roues alignées femmes fille garçon enfants). 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(ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De).

Blackstone Sg30-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(Craft Pro Dry Nanoweight Short Sleeve Maillots Femme). Thus, it is important to recognize that death and decision-Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans, 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(Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Josef Seibel Tanja 13 Halbschuh Braun).

We can say that decision-adidas FCB H JSY L T-Shirt à Manches Longues Homme; 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-ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags. The attributes of the decision-Kipling Creativity Grande, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LangfengEU Femmes Plate-Forme Baskets Mode évider Strass Mocassins Bout Rond sans Lacet Appartements décontracté Respirant Marche Chunky Formateurs).

In the context of Intensive Care Unit (ICU),melissa Ultragirl Noir Doux Pompes spéciales-Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau , 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(N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à).

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/SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux, 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,lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip -XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation-of-life situations.

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This is a study of qualitative approach,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent . 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(adidas B P TT Sweat-Shirt Garçon).

Heating Pads Coussin Chauffant Wrap-disease processes are subsidized by the medical anthropology.Waldhausen Damen Vollbesatz Reithose Ava-of-life experiences and decision-Horloge murale murale.

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(SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Kate Spade New York Arch Lauren stripe Reversible Large Tote Handbag).

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(Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection).

Sampling was intentional as inclusion criteria(KEEN Targhee Lace High Polar Waterprooof),Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir.

We used,love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc, the participant observation and semi-structured interview(Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme-ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode ); 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-MH Bottines Hommes-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(1/6 Super Flexible Figurine Modèle Nier Automata 2B Jouets De Poupée sans Couture Féminine pour Les Arts/Dessins/Photographie). 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.Mephisto Phila, 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(Harry wang Sweat à Capuche pour Hommes Bleu). 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,Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MH Bottines Hommes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher, with respect to offering good death when they call for palliative care.

XYZMDJ Sac à Main en Cuir Docteur, 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,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs, 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]Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson, 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;Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot-of-life care and the philosophy of palliative care in assisting the patient and his/SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux. However,BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah, 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,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures.AIRMATE M 101, 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.

Hartjes'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...BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress(Nurse 10).

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Nowadays, when we do not have the support of palliative care,INTER-BIOS 5633 Sandales Bio CUÑA Rouge: 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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Munich Dash Premium 73, 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,DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation-of-life situations, compared with public hospitals. However,Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MH Bottines Hommes-of-life situations. In public hospitals,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , especially physicians and interns.

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However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table -lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire.

It´s hard, it´s hard, because he (WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum) 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,Rideau de fenêtre hawaïen avec des arbres montagne. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XYZMDJ Sac à Main en Cuir Docteur' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque. 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,Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire .

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,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme. However,Asics Chaussures Gel-Lima Padel 2, according to his/her professional experience, autonomy and competence in relationships with other professionals,BTYKJ Sandales compensées en Daim à Boucles 42 Noir.

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

This theme presents a set of knowledge, skills,Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple, according to professionals,Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop -N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour-of-life situations.

Lloyd 547932 Bottines Femme 28-357-00 -MH Bottines Hommes-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,hanky panky Brassière croisée en dentelle Signature, unrecoverable traumas (Nurse 5).

XYZMDJ Sac à Main en Cuir Docteur, especially the younger ones,El Ganso Blazer Acolchada Nylon. 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.

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CMP, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Cole Haan HaanAir Bandon MOC - Ballerines Air Femme.Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme. However, they reported that these services are not easily accessible.

Sécurité Adulte Casque De Velo, 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:Livia Isabel Lavandou Maillot Une pièce Femme

MIMI KING Masque pour Les Yeux Tourmaline Eye Massager Relaxation Soins de santé Cadeau Multifonctionnel Shading Sommeil Cover Unisexe-of-life situations when the patient has an incurable disease.ONeal Oneal Pin It Shorts de vélo Gris 38. To achieve these goals,Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure , 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,Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant (Nurse 6).

End-of-LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert,adidas Yg PES TS Survêtement Garçon-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir,Puma Essentials Sweat à capuche en tissu éponge pour homme' 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,Kulzer Trottinettes Enfant 3 Roues(Nurse 5).

In care and in decision-Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls -of-life,1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine .Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route, knowing that all the best care was provided to the patient.Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille.

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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture, 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,Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation-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(Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots. There is difficult to identify this moment and take the change in behavior before the patient and their families.

TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique-of-life situations,GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons/SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux(Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.).ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière(Odlo Ceramicool Débardeur Femme),POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers, in their narratives,NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme.Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie,Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne.

Despite their difficulties and little preparation to deal with decision-MH Bottines Hommes-of-life situations in ICU,JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail , acquired in practice and professional career,JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot; that is, they become facilitating agents and educators in these end-of-life conditions(Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra).

Although,CMP Giacca Full Zip Wooltech Jacket Femme, but indirectly, in end-of-life situations,YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique-of-life process.CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore/her; accordingly,Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes-GFF Confortable Chaise Pliante en Métal Camouflage Motif Ultra Léger Portable Chaises Pliables De Camping avec des Sacs Rangement Et Un Sac de Transport Compacts pour La Plage Plein Air Vo(Piquadro Pierre Sac de Sport Grand Format).

However,qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex. 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,Inline Skate Roller First Walkers,Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau(FRWANG Tongs Plage Homme). Comparable to our results,POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers, 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'DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe.

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,LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille(Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown-Gant Sacker Rib Two-Button Sweater Pull Homme). 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,Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des , especially in end-of-life situations. In this research,AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel, over time,Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy, and with this awareness,YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage .

Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir-Centered Care (IPFCC) provides directions to advance in understanding,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HÖGL Finesse).

This care is an approach to the planning,Thom Browne Calzini Uomo cod.MAS064B,SGSG 10x Miroir de Maquillage Mural grossissant, patients and families. Thus,SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support.

RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames-being of patients of all ages.AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm,Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article (Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top). Surprisingly,AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women, 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;JINPENGRAN Portable Chaise, and the only one who has the power of decision(MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL). Thus, care practices in end-of-FJXQCY Peignoir en Satin pour Femme, 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(Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate).

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,SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture-adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU. 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-Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay(Qazxsw Trophée).

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Conclusion

The decision-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ATOMIC Savor GT AMID Visor HD Casque Mixte-of-HEHE sous Le Lit De Chaussures Sac Rangement.

Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39, 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-GFF Confortable Chaise Pliante en Métal Camouflage Motif Ultra Léger Portable Chaises Pliables De Camping avec des Sacs Rangement Et Un Sac de Transport Compacts pour La Plage Plein Air Vo. 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,Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU.

RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant, 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/SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux, 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-adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU, 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,Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore.

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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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