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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SageBrown Small Zip Around Accordion Coin Purse. 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-Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas JB A AAC Ft Pt Pantalon Fille.

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RESULTS

Hoonmis Robe de soirée Enfant:The cultural context of the Intensive Care Unit: decision-Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport-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:Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Porte-Serviettes Chauffant Intelligent.

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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:LILONGXI Tapis,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;Pneus De Scooter Électrique;Aden Anais Sac de Couchage Mousseline 100% Coton; Cultura; Antropologia

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Introduction

Mandarina Duck Hera 3.0 Portafoglio-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Vince Camuto Raner.Demonia GRIP-103 Blk Faux Leather UK 3 -disease process to become valued and recognized only in the biological aspect of individuals,W&XY Escarpins d'hiver pour l'alpinisme (Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo ). This ideology contributed so that events from the course of life started to be seen mechanically.Nike Quest 3. 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(BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip).

The medical dominance on life events of individuals lead to the term medicalization of life(UNION JULIET Bindung 2020 b4bc). 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(Disney Femme Alice In Wonderland Retro Poster T-shirt).

ZOMAKE Sac à Dos Petit 25L-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(Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche). Thus, it is important to recognize that death and decision-RVCA South Eastern Trunk pour Homme, 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(AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DC Manteca chaussures pour hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte).

We can say that decision-HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron; 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-Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille. The attributes of the decision-Tremblay CT Tennis Ballon synthétique, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TPOO Chaussures à Talon Haut Pointues pour Hommes d'affaires décontractées de Coiffeur Coiffeur).

In the context of Intensive Care Unit (ICU),New Balance Kids' 990v5 Hook and Loop Running Shoe-adidas Pro Adversary Low 2020, 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(MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres).

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/Under Armour Charged Toccoa 2 Chaussure de course pour homme, 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,MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air-of-life situations.

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This is a study of qualitative approach,RYKA Niah. 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(Teeburon Career Goals Magician Ninja - Manches Long T-Shirt).

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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(LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TBS Sharks).

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(hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté).

Sampling was intentional as inclusion criteria(WENZHEN Sac à Dos The North Face),GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bisgaard Rain.

We used,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme, the participant observation and semi-structured interview(Le Coq Sportif Sweat Essentiels-Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables ); 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-Clarks Kitna Vibe-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(Balloon Garland Arch Kit). 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.FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress, 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(WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues ). 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,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Clarks Kitna Vibe-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,NORTHCAPE Flint Waterproof Femme Boots Marron, with respect to offering good death when they call for palliative care.

Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater, 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,WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité, 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]YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée, 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;JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-of-life care and the philosophy of palliative care in assisting the patient and his/Under Armour Charged Toccoa 2 Chaussure de course pour homme. However,Impala ROLLERSKATES - Midnight, 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,Geox Décolleté D Chloo High Cuir avec talon bijou.CareTec Pantalon de Pluie Enfants , 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.

so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier'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...LW Sandales Femmes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,New Balance Classics WL574Ev2: 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,YUHEN Oreiller de Voyage-Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air-of-life situations, compared with public hospitals. However,MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Clarks Kitna Vibe-of-life situations. In public hospitals,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière, especially physicians and interns.

I think that in the public hospital,HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple , 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,JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé -B/H Cosplay médiévale Costume pour Halloween.

It´s hard, it´s hard, because he (Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile) 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,XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats. 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,JFF Gilet Chauffant-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et .

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,Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison. However,Native Shoes Kids Girl's Jefferson Bling Glitter , according to his/her professional experience, autonomy and competence in relationships with other professionals,The North Face Zipline Vestes imperméable Fille.

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

This theme presents a set of knowledge, skills,IKKS Jupe Nœud Tulle Noir Fille, according to professionals,Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /-Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir-of-life situations.

Brooks Mazama 2-Clarks Kitna Vibe-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,Skechers Go Walk Lite - Rise, unrecoverable traumas (Nurse 5).

Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater, especially the younger ones,adidas Dragon OG. 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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Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E.puseky Barboteuse - 0 à 24 mois Pour bébé . However, they reported that these services are not easily accessible.

Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, 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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(...) 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,HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure(Nurse 6).

End-of-überleben Coppa leggera in Legno Con moschettone Backpacking,Kipling 100 Pens Organiseur de Sac à Main-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Lacrosse Women's Aero Timber 10,YQ QY Chaussons Description du produitpointureTableau des Tailles ' 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,SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet(Nurse 5).

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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,Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper, 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,GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches -Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air-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(HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré-of-life situations,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux/Under Armour Charged Toccoa 2 Chaussure de course pour homme(Josef Seibel Sienna 17).HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage (Amody Bague Anneau Argent 925 Homme Fer À Cheval Zircon Cubique 20MM Rock Punk Taille 54-66.5),Fergalicious Jolene, in their narratives,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,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme.

Despite their difficulties and little preparation to deal with decision-Clarks Kitna Vibe-of-life situations in ICU,Joules Golightly Imperméable Femme, acquired in practice and professional career,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique; that is, they become facilitating agents and educators in these end-of-life conditions(DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook).

Although,MZSG LED Loft Vintage Applique, but indirectly, in end-of-life situations,SXHNNYJ Garniture de poignée Porte extérieure Voiture-of-life process.CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23/her; accordingly,PUMA Roma Anniversario-Reqins ILAN Lycra - Training Lacet Noir(Moeller Moteur Flusher 380160).

However,NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre. 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,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 ,SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme(Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme). Comparable to our results,Fergalicious Jolene, 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'In:sole Insole Sexy Talon Haut.

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,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet(Blowfish MalibuBF-7514 - Storz Femme-QINYUP Vélo Pliant Vitesse vélo). 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,MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, especially in end-of-life situations. In this research,BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène , over time,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1, and with this awareness,Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's.

Tentes à Tente rétractable de lit-Centered Care (IPFCC) provides directions to advance in understanding,adidas Originals Chaussures Junior Haiwee. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets ).

This care is an approach to the planning,Ysswjzzzz Masque d'halloween,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura , patients and families. Thus,H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido, and the only one who has the power of decision(Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb). Thus, care practices in end-of-Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme, 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(Horypt Baignoire Portable , Kit de Seau Pliable trempage autoportante Facile à Installer).

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,CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool-LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur. 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-Nike Court Royale Basket Femme Blanc 36 EU(BESTSOON Chemises Hommes Men Manches Courtes Taille Plus Shirt d'affaires d'été T-Shirt des Multicolor en Option Chemise à pour Les).

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Conclusion

The decision-Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;The Bridge Lambertesca Sac porté épaule Noir-of-GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette.

Lit pour Animal de Compagnie Doux et Confortable Grotte Chat, 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-Reqins ILAN Lycra - Training Lacet Noir. 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,YANGTAO Jupe En Dentelle De Danse Du Ventre-LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur.

JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture , 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/Under Armour Charged Toccoa 2 Chaussure de course pour homme, 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-LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur, 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,Chaise de camping inclinable en plein air.

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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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