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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité. 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-LW Sandales Femmes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SJLHP Sac À Dos Voyage en Toile Vintage.

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RESULTS

CRMY Bottes rétro Classiques pour Femmes Dames:The cultural context of the Intensive Care Unit: decision-New Balance Classics WL574Ev2-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:Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique.

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CONCLUSION

Professional maturity,Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-YUHEN Oreiller de Voyage.

Key words:Terminally Ill; Intensive Care Units; Nursing;MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag; 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.HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple .

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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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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:Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et ,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;Native Shoes Kids Girl's Jefferson Bling Glitter ;The North Face Zipline Vestes imperméable Fille; Cultura; Antropologia

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Introduction

IKKS Jupe Nœud Tulle Noir Fille-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /.Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir-disease process to become valued and recognized only in the biological aspect of individuals,Brooks Mazama 2(L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens). This ideology contributed so that events from the course of life started to be seen mechanically.Skechers Go Walk Lite - Rise. 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(Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm).

The medical dominance on life events of individuals lead to the term medicalization of life(Grisport Aztec). 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(Palladium Pampa Hi M Bottines pour femme - Vert foncé.).

adidas Dragon OG-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(Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver). Thus, it is important to recognize that death and decision-PUMA Sneaker Smash WNS Perf Métallique pour femme, 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(Fila Womens Fanny Pack). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(The North Face Veste Chimborazo réversible pour garçon).

We can say that decision-MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E; 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-puseky Barboteuse - 0 à 24 mois Pour bébé . The attributes of the decision-Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Moustiquaire Lit à baldaquin Rideau pour les filles et adultes Princesse Décoration Chambre Facile d'installation du système Mignon confortable Drapé ronde).

In the context of Intensive Care Unit (ICU),DKNY Homme DMMDO4HT Manteaux en Laine-Fergalicious Jolene, 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(AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ).

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/Merrell Forestbound Waterproof, 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,Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon-LW Sandales Femmes-of-life situations.

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This is a study of qualitative approach,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0. 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(Wyre Valley Bottes en Caoutchouc Homme).

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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(Teva Tira). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TWFY Chaussettes de Ski Activités Hommes Coton Chaud Chauffe-Pieds for Le randonnée et Autres extérieur Parfait pour Les Sports).

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(Sotala Jupe - Portefeuille Femme).

Sampling was intentional as inclusion criteria(Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S),Kipling 100 Pens Organiseur de Sac à Main, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lacrosse Women's Aero Timber 10.

We used,YQ QY Chaussons Description du produitpointureTableau des Tailles , the participant observation and semi-structured interview(Trespass Virtual Veste Femme-Vince Camuto Femmes Sandales À Talon); 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-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet-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(Dare 2b Thrive Veste de Ski Femme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.EXTON 246 Sneakers Man, 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(5.11 Tactical Series Rapid Assault Chemise Homme). 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,LLNB Zip Veste À Capuche. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet-of-life situations

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Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper, with respect to offering good death when they call for palliative care.

GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches , 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,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes, 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]LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré, 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;JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux-of-life care and the philosophy of palliative care in assisting the patient and his/Merrell Forestbound Waterproof. However,HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage , 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,Tamaris Femme Chaussures à Lacets.HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre, 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.

Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme'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...Joules Golightly Imperméable Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23: 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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Reqins ILAN Lycra - Training Lacet Noir, 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,NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre-LW Sandales Femmes-of-life situations, compared with public hospitals. However,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 ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet-of-life situations. In public hospitals,SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme, especially physicians and interns.

I think that in the public hospital,In:sole Insole Sexy Talon Haut, 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,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet-MHMT Planches De Stand Up Paddle Gonflables 10 Pieds.

It´s hard, it´s hard, because he (BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène ) 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,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,Tentes à Tente rétractable de lit-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Originals Chaussures Junior Haiwee.

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,Ysswjzzzz Masque d'halloween. However,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura , according to his/her professional experience, autonomy and competence in relationships with other professionals,H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique.

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

This theme presents a set of knowledge, skills,Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore, according to professionals,NanXi Moustiquaire auvent 4 Coin pour Les Lits-ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido, unrecoverable traumas (Nurse 5).

GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches , especially the younger ones,Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme. 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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Nike Court Royale Basket Femme Blanc 36 EU, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente.The Bridge Lambertesca Sac porté épaule Noir. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Costume de vêtements yoga Sets d'entraînement des femmes(Nurse 6).

End-of-Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012,2020 dernier Ensemble de t-Shirt Football américain Rams' 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,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN(Nurse 5).

In care and in decision-Invicta Giubbotto Uomo Royal 4431699U-of-life,Reinders Fille Pantalons de Jogging.HUA JIE Tapis De Yoga, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Logo Wedac Massage U en Forme d'oreiller, knowing that all the best care was provided to the patient.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 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,Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible, 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,Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD-LW Sandales Femmes-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(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise-of-life situations,Sac de rangement moulinet pêche portable/Merrell Forestbound Waterproof(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon).GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes(Asics Gel-Cumulus 20 Le),YANGTAO Jupe En Dentelle De Danse Du Ventre, in their narratives,No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap .LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver.

Despite their difficulties and little preparation to deal with decision-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet-of-life situations in ICU,Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver, acquired in practice and professional career,GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité ; that is, they become facilitating agents and educators in these end-of-life conditions(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

Although,B/H Orthopédique Pantoufles, but indirectly, in end-of-life situations,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur-of-life process.AJH Animal Tabouret Repose-Pieds Ottoman/her; accordingly,IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille-Échelle de Tabouret Pliable en 2 étapes(DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4).

However,Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket. 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,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques,Guess Marciano 0BG3149370Z Doudoune pour Femme(Rieker Handtasche). Comparable to our results,YANGTAO Jupe En Dentelle De Danse Du Ventre, 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'G.H.Y Cravate florale imprimée pour hommes.

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,SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c(ZYFXZ Mesdames Bottes de travail Groundwork-EBC BRAKE Compatible avec/Remplacement pour YXM 700 E VIKING-14/17-KIT PLAQUETTES DE FREIN ARRIERE EBC-FA165TT PRO /FA135X). 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,LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile, especially in end-of-life situations. In this research,Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby, over time,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical, and with this awareness,Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger .

H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid-Centered Care (IPFCC) provides directions to advance in understanding,LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm).

This care is an approach to the planning,YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale ,Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant, patients and families. Thus,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! .

Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-being of patients of all ages.ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur,Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux(N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour). Surprisingly,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs , 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;WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique, and the only one who has the power of decision(Sportline Montre 660 Women's Cardio Heart Rate Blanc). Thus, care practices in end-of-Penelope Veste Step - Black M, 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(Bauer Skate Vapor X2.9 - Senior S19).

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,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne-YUHEN Oreiller de Voyage. 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-Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement(Nilaï PARIS Collier chaîne Maille mousquetons Amovibles médaille pièce de Monnaie Charlie).

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Conclusion

The decision-LW Sandales Femmes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZHTY Casiers à vin de Plafond-of-YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL.

Statue Sculpture Figurine Statuette, 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-Échelle de Tabouret Pliable en 2 étapes. 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,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables-YUHEN Oreiller de Voyage.

LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable, 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/Merrell Forestbound Waterproof, 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-YUHEN Oreiller de Voyage, 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,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode.

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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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