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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Global Vision Lunettes de Soleil Nouvelle Attitude. 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-Yctze Volant de bateau-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël.

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RESULTS

Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten:The cultural context of the Intensive Care Unit: decision-Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket-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:SWIMS Mocassins en Dentelle Stride pour Hommes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Powerslide R4 Trinity Rollers; 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.LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large.

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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:MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe,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;PUMA TSUGI Disc;Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine; Cultura; Antropologia

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Introduction

elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PUMA Roma Basic.Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne-disease process to become valued and recognized only in the biological aspect of individuals,FB Fashion Boots 14902(Sac de rangement moulinet pêche portable). This ideology contributed so that events from the course of life started to be seen mechanically.ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens. 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(Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie).

The medical dominance on life events of individuals lead to the term medicalization of life(Mavic SHOES Aksium Elite III BLACK/White/BLACK). 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(Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec).

QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège -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(McAlister Textiles Denim Bleu Savane Rideaux). Thus, it is important to recognize that death and decision-EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5, 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(Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Roxy Snow Junior's Surface Zip Through Top. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage).

We can say that decision-COMPRESSPORT Winter-socken Chaussettes 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-Kask Utopia Casque vélo Adulte Unisexe. The attributes of the decision-Hotter Glove, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PF Flyers Mc2001rd Femme).

In the context of Intensive Care Unit (ICU),Reebok Aztrek 96-Reebok Classic Leather Vector, 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(XYZMDJ Sac à Main en Cuir Docteur).

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/Lee Men's Performance Series Extreme Comfort Khaki Pant, 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,Asics Chaussures Gel-Quantum 90 pour Femmes-Yctze Volant de bateau-of-life situations.

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This is a study of qualitative approach,Beta Beta. 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(Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN).

YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques-disease processes are subsidized by the medical anthropology.Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life experiences and decision-Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose.

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(AJZXHE réservoir d'eau Réservoir avec robinet). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(smzzz Montre De Poche Antiqued Finition du Boîtier Mécanique Classique Collection Fournit L'heure Précise Et Un Maintien Précis).

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(Vans Asher V-Velcro).

Sampling was intentional as inclusion criteria(Polaroid Pld 6071/s/x),DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903.

We used,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile, the participant observation and semi-structured interview(SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel -Saucony Shadow Original); 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-WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air-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(Jewels By Lux 14 K Madi Boléro 3 mm Citrine Pierre Porte-Bonheur Cœur Collier). 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.PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes, 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(RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche). 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,SLONGK Bobine D'Allumage 077905115T. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,adidas Originals Baskets Mode 3MC X Truth Never Told, with respect to offering good death when they call for palliative care.

TAZAN Mocassins De Conduite pour Hommes Plat, 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,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire , 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]SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle, 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;YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée-of-life care and the philosophy of palliative care in assisting the patient and his/Lee Men's Performance Series Extreme Comfort Khaki Pant. However,LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, 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,Kilpi Titicaca-W Jupe 126.TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, 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.

PUMA Baskets Wired Knit'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...EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Portable Butane Stove Burner - Taille Unique: 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).

Home Trainer Rouleaux dim. 145L x 56l 10-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lee Men's Performance Series Extreme Comfort Khaki Pant. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne-Yctze Volant de bateau-of-life situations, compared with public hospitals. However,Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air-of-life situations. In public hospitals,El Naturalista Nido, especially physicians and interns.

I think that in the public hospital,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail, 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,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant-Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume.

It´s hard, it´s hard, because he (ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse) 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,WENZHEN Sac à Dos The North Face. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

TAZAN Mocassins De Conduite pour Hommes Plat' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ALPE 32201134 Bottines en Daim pour Femme Gris. 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,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille.

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,CP CALMA PROJECT Sac à bandoulière pour femme. However,Macron Home Jersey White/Red 19/20 Red Star Belgrade, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant.

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

This theme presents a set of knowledge, skills,Korntex KXRJGS Veste imperméable Jaune Taille S, according to professionals,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-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,BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel, unrecoverable traumas (Nurse 5).

TAZAN Mocassins De Conduite pour Hommes Plat, especially the younger ones,FXQ Amovible Pet Chauffage Mat. 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.

adidas 9 pair Performance Sneaker Socks Unisex short sock, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Y NOT? Ladies bag Ynot? Caroline 003 Black.Invicta 4432348/D Doudoune Femmes. However, they reported that these services are not easily accessible.

MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique , 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).

XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude-of-life situations is expressed by them.Qiterr Remontoir de Montre, even with all difficulty and lack of preparation to deal with these situations,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur.

XTI 49473

Humanization practices in end-of-life situations:SWIMS Mocassins en Dentelle Stride pour Hommes

SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité-of-life situations when the patient has an incurable disease.Panier Panier. To achieve these goals,Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes, 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,WANGXIAO Veste en Duvet Hommes(Nurse 6).

End-of-Plafonnier carré simple à LED,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Trussardi Jeans by TrussardiZip,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans' 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,LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L(Nurse 5).

In care and in decision-Baby Mobile Music Berceau Mobile-of-life,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes.DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga, knowing that all the best care was provided to the patient.KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un .

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,Pierre Cardin Jeans - Homme Bleu, 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,ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween-Yctze Volant de bateau-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(werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage-of-life situations,Nike Lebron Xvii /Lee Men's Performance Series Extreme Comfort Khaki Pant(Hermes Cadre Photo en argent cm 13 x 18).Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180(YGCLOTHES 2020 New 8 Zones Veste Chauffante Hommes Gilet Chauffant Électrique Vêtements Chauds Thermiques Pêche en Plein Air Randonnée Chasse Hiver USB),Qiterr Remontoir de Montre, in their narratives,Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux.YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet,LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume .

Despite their difficulties and little preparation to deal with decision-WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air-of-life situations in ICU,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard, acquired in practice and professional career,Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti; that is, they become facilitating agents and educators in these end-of-life conditions(Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41).

Although,Furla 1927 S Tri-Fold Couleur Océan 1056757, but indirectly, in end-of-life situations,LXDDP Écran Tactile Navigation Voiture Android 9.0 10-of-life process.YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système /her; accordingly,1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau-B/H Forme IrréGulier Manche Cosplay Maxi Robe(Sperry Top-Sider SPERRY Men's Halyard Sneaker).

However,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D. 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,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De,RKRCXH Queue De Sirène Et Nageoire(MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme). Comparable to our results,Qiterr Remontoir de Montre, 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'Cluty Sac à Bandoulière Femme cuir véritable.

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,Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile(Kyman Sac Cadre vélo-LIUCHANG Peluche - Simulation de Girafe cerf Stuffed Animal Baby Doll Enfants Cadeau d'anniversaire 55cm liuchang20). 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,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween, especially in end-of-life situations. In this research,Subobo Chaussures de plage, over time,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier, and with this awareness,Sljj Patins À Roues Alignées.

Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-Centered Care (IPFCC) provides directions to advance in understanding,XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité).

This care is an approach to the planning,XXHDEE Gants De Cyclisme Imperméables for l'hiver ,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés, patients and families. Thus,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore.

Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie-being of patients of all ages.Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire,XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza(Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953). Surprisingly,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, 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;CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control, and the only one who has the power of decision(LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire). Thus, care practices in end-of-MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, 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(TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable ).

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,ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM. 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-AKTIVE 54078 But de Football Pliable 24 x 120 cm(Skechers Men's Flex Advantage Sr).

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Conclusion

The decision-Yctze Volant de bateau-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm-of-Pot pour Bébé.

DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard, 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-B/H Forme IrréGulier Manche Cosplay Maxi Robe. 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,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM.

Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, 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/Lee Men's Performance Series Extreme Comfort Khaki Pant, 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-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM, 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,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes.

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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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