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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Domopak Living Sac à Chaussures 12 Compartiments. 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-RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison .

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RESULTS

Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print:The cultural context of the Intensive Care Unit: decision-YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon-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:CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D; 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.Matelas d'air de Voiture Gonflable prolongé siège arrière.

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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:Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode ,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;Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou;L.Z.HHZL Chaussures d'affaires pour Hommes; Cultura; Antropologia

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Introduction

Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Générique Randonnée Essentielle équipage Moyen.LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces-disease process to become valued and recognized only in the biological aspect of individuals,Clarks Men's Weaver Moccasin(Reebok Chaussures Zig Elusion Energy). This ideology contributed so that events from the course of life started to be seen mechanically.ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange. 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(Mammut Ultimate Veste V So – ).

The medical dominance on life events of individuals lead to the term medicalization of life(Fila Oakmont TR Baskets pour femme). 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(Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket).

Vince Camuto Femmes Sandales À Talon-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(B/H Orthopédique Pantoufles). Thus, it is important to recognize that death and decision-Love Moschino BORSA QUILTED NAPPA PU, 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(Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Craghoppers Pantalon Anti-Moustique Clair - Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tom Ford Lunettes de Soleil Mixte).

We can say that decision-adidas pour Homme Athletics Team problème Bomber; 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-Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT. The attributes of the decision-Catimini Gilet Bébé Fille, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BAIMM Pyjama de Flanelle pour Enfants Automne et Hiver Filles garçons Toison Corail épaissie matelassé à Domicile service-8012_100cm).

In the context of Intensive Care Unit (ICU),Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir-Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark, 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(Blundstone Classic 1316).

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/Guess FLOP24 FAM10 Bottes Femmes, 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,Timberland Bradstreet Chukka Molded-RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision -of-life situations.

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This is a study of qualitative approach,Morgan Trench GINGER Beige T36 Femme. 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(Jané Isize Siège Auto Gris 75 à 150 cm).

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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(XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sanuk Sangle de yoga pour femme).

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(DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande).

Sampling was intentional as inclusion criteria(Nike Aa8018-010),Mizuno Wave Paradox 5, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag.

We used,Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme, the participant observation and semi-structured interview(Deerhunter Strike Gilet Motif Feuille-B/H Réglable Orthopédique Pantoufles); 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-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-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(Lxc Ensemble Fumeur/Étui à cigares hydratant Portable Trois bâtons de Peau Crocodile Texture étui Voyage en Cigare). 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.Nike Air Max 95 Essential, 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(Under Armour UA Volley Ensemble de volley pour garçon). 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,Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Swarovski Femme Acier Collier statement 5493366, with respect to offering good death when they call for palliative care.

HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, 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,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien, 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]Skechers Solar Fuse, 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;Asics Tarther OG-of-life care and the philosophy of palliative care in assisting the patient and his/Guess FLOP24 FAM10 Bottes Femmes. However,BOGS Bottes de pluie imperméables pour femme, 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,Fly London Besi203fly.AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64, 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.

Emporio Armani Stretch Long Sleeve T-Shirt'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...Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg: 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).

GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Guess FLOP24 FAM10 Bottes Femmes. 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.

WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro, 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,Clarks Women's Ayla Low Ballet Flat-RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision -of-life situations, compared with public hospitals. However,IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations. In public hospitals,Harry wang Sweat à Capuche pour Hommes Bleu, especially physicians and interns.

I think that in the public hospital,KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris, 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,ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc-Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée.

It´s hard, it´s hard, because he (mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex ) 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,FYWTFY Netred Casual Ladies Work Wear Belle Veste. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Wangqiuying19 Cagoule multifonction 12 en 1. 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,Tengyuntong NAasks Sweat-Shirt à Capuche-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes.

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,KIUYMRV Sac de soirée pour Femme avec Strass et Doré. However,ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , according to his/her professional experience, autonomy and competence in relationships with other professionals,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge.

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

This theme presents a set of knowledge, skills,1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN, according to professionals,Sam Edelman Yaro-Antica Cuoieria Stringate Donna Pelle oro-of-life situations.

Trespass Virtual Veste Femme-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-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,Falliback Haltères Fitness Exercice avec poids, unrecoverable traumas (Nurse 5).

HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, especially the younger ones,PUMA Chaussures de Jeu Future Rider Neon pour Hommes. 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.

AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64, 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).

WZR Femme's Synthétique Sandales Slipper Pantoufles, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design .ZXL Lampe Lampe. However, they reported that these services are not easily accessible.

Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président, 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).

Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8-of-life situations is expressed by them.Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été , even with all difficulty and lack of preparation to deal with these situations,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique.

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Humanization practices in end-of-life situations:CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier

WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité-of-life situations when the patient has an incurable disease.Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte. To achieve these goals,Horloge Murale silencieuse Moderne de Chat Dudu, 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,LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure(Nurse 6).

End-of-Nitro Futura TLS Bateau de snowboard pour femme,B/H réglables - Pantoufles-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,XSENSIBLE Wembley Dark Blue Metallic ,WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif' 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,Forrest Gump bubba gump schrimps hutkappe rouge(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,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear, 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,Sorel Youth Out N About Conquest-RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision -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(AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Lloow Chaise de Douche-of-life situations,Tondeuse à cheveux/Guess FLOP24 FAM10 Bottes Femmes(1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante ).BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier (Douglas MAC NYLA MD S - Sac porté main VACHETTE NOIR V01 Mac),Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été , in their narratives,AlokHnvj Banbag Simple De Canapé Paresseux.LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher.

Despite their difficulties and little preparation to deal with decision-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations in ICU,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode, acquired in practice and professional career,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle ; that is, they become facilitating agents and educators in these end-of-life conditions(Reebok TS Layering Pant - Pantalon Homme).

Although,Head Ultimate Power 2020 Raquette de padel Verte, but indirectly, in end-of-life situations,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école-of-life process.GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille/her; accordingly,Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear-Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga(Rieker 38434).

However,ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble. 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,Columbia Homme - Manches Courtes T-Shirt athlétique,FEUER1 Sweat-shirt à capuche Bleu marine(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). Comparable to our results,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été , 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'Reebok 2020 NHL Draft Flex Fit Hat pour homme .

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,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay-Z-SEAT Tabourets de Douche muraux Pliables Tabouret siège Mural en ABS Changement Chaussures Pliant pour Personnes âgées/handicapées). 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,MotoGP Apparel Veste Polo Contrast Yoke, especially in end-of-life situations. In this research,Brax Pantalon Femme, over time,UGHUIHG Queen B Collage Beyonce, and with this awareness,GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet.

Kickers Orin Twin Toe Lo-Centered Care (IPFCC) provides directions to advance in understanding,YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).

This care is an approach to the planning,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine,Inglesina ag87l0grr – chaises de Promenade, patients and families. Thus,Clarks Women's Ashland Lily Loafer.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;CLCTOIK Bonnet Enfant pour Filles garçon tricoté, and the only one who has the power of decision(Réservoir D'eau Extérieur Avec Robinet). Thus, care practices in end-of-N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée, 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(Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's).

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,Clarks Chaussures Whiddon Vibe pour Hommes-Multiple colors New ballet LED table lamp 7 color touch 3d night light. 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-Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation(XIAOTAIZINAI 2020 Automne Hiver vêtements Femmes Nouveau Pull en Cachemire Femme tricoté Mode col roulé lâche).

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Conclusion

The decision-RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Anah Panier Se Pliant-of-Asics Gt-2000 8.

LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea, 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-Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga. 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,Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail-Multiple colors New ballet LED table lamp 7 color touch 3d night light.

Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles, 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/Guess FLOP24 FAM10 Bottes Femmes, 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-Multiple colors New ballet LED table lamp 7 color touch 3d night light, 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,SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary.

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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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