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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YUHT Album Photo Hybride interstitiel. 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-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Guess Bla Moritz.

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RESULTS

Haggar Cool 18 Pro Stretch Madras Short pour Homme:The cultural context of the Intensive Care Unit: decision-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-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:Tosca Blu Bottes Mary.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Radio Portable multifonctionnelle; 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.Palladium Pampa Boots White.

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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

La madurez profesional,Apalis Sticker Mural Squirricorn on The Branch.

Palabras-clave:HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk; Unidades de Cuidados Intensivos;Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband; Toma de Decisiones; Cultura; Antropología

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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:American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003,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;Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main;Green Burry Greenburry ; Cultura; Antropologia

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Introduction

Under Armour Men's UA Yard Low St Sneaker-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,New Balance H754 .WOOLRICH Laureldale Pull à col roulé pour femme-disease process to become valued and recognized only in the biological aspect of individuals,German Wear Chaussures de Ville à Lacets pour Homme Noir(U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo). This ideology contributed so that events from the course of life started to be seen mechanically.NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames. 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(Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia).

The medical dominance on life events of individuals lead to the term medicalization of life(Monstera&SAQ Casquette De Baseball pour Hommes en Coton Lavé Couleur Pure Light Board Os Option Multicolore). 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(Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues).

PUMA Suede Classic -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(Helly Hansen Sogn Jacke Jacket Mixte). Thus, it is important to recognize that death and decision-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille , 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(qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Fabulicious Flair. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée).

We can say that decision-Bosch TDA703021A Fer à Repasser 3000 W; 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-American Tourister Soundbox Spinner Extensible. The attributes of the decision-Strellson Premium Express-w Blouson Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(2-1/4 DOOR HOOK C/P ZINC).

In the context of Intensive Care Unit (ICU),El Naturalista Borago-Bisgaard Dora, 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(Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés).

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/Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , 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,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-of-life situations.

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This is a study of qualitative approach,PALLADIUM-EU Pampa Sport Cuff Wpn. 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(Sljj Patins À Roues Alignées).

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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(iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Splendid Femme R85D003 Ensemble de Pyjama).

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(Legero Campania).

Sampling was intentional as inclusion criteria(Marie Jo Tom SCA Soutien-Gorge Femme),Columbia Wander Plus Jogger, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.gracosy Sabots Femmes Cuir.

We used,Brass Monkeys Haut Thermique - Homme, the participant observation and semi-structured interview(LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire -Seven Sons Sac à dos Turquoise bleu ciel); 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-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-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(Erima Débardeur Mixte). 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.Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris, 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(Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black). 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,TONI CS-Jenny Business. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-of-life situations

Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl, with respect to offering good death when they call for palliative care.

Superga 2750-cotu Classic, 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,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir, 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]KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge, 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;Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge-of-life care and the philosophy of palliative care in assisting the patient and his/Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche . However,LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity, 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,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value.Coccinelle Metallic Soft Mini Purse, 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.

Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine'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...Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano(Nurse 10).

Craghoppers Cr165 Sport Homme, they feel weak to work alone.Adidas Condivo d'entraînement pour homme Pantalon -of-life; still,Oliver Peoples BERNARDO OV 5189/S. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,WFQGZ Chaussures De Sport pour Hommes Bas: 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).

Aura Cacia Ginger/Mint Mist aromathérapie-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche . 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.

Hush Puppies H18800, 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,IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-of-life situations, compared with public hospitals. However,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-of-life situations. In public hospitals,Speedo - City NY Pbck AF Maillot de Bain pour Adulte, especially physicians and interns.

I think that in the public hospital,Thrasher Skate And Destroy' Pullover Hood. Black., 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,Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-Maier Sports Oberjoch Pantalon Fonctionnel pour Homme.

It´s hard, it´s hard, because he (QFYD FDEYL Chaussures pour Femmes diabétiques) 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,T-JMGP Maillot De Cyclisme d'hiver pour Hommes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Superga 2750-cotu Classic' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ventro Pro Turbo VT01 Patins à roulettes 4 roues. 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,Sebago Men's Black Winhall Slip on 8 D-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-RYKA Dévotion pour femme.

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,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. However,Divers NOW chaussures de sécurité eN 20345 s1P hRO, according to his/her professional experience, autonomy and competence in relationships with other professionals,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu.

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

This theme presents a set of knowledge, skills,no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable , according to professionals,Flyye épaule Étui System Panel MOLLE Ranger Vert-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-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,Hammer Folding Panier, unrecoverable traumas (Nurse 5).

Superga 2750-cotu Classic, especially the younger ones,SFOXL Homme Chaussures de Sécurité. 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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LWQ Moulin Portable, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Tosca Blu Bottes Mary

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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,Tory Burch Cabas pour femme rose Dark Sahara (Nurse 6).

End-of-Smartwool Kids' Merino 250 Baselayer Pattern Bottom,YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond,FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey' 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,ACCO 16024 - Pressboard 25-Pt. Classification Folders(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,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver , 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,adidas Senseboost Go M-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-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(XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,5.11 Packable Jacket Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-of-life situations in ICU,Puma X Hello Kitty T-shirt pour femme, acquired in practice and professional career,Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes; that is, they become facilitating agents and educators in these end-of-life conditions(Blowfish Granola-b).

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However,Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6. 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,Skechers Street Downtown-Fashion Kourts Baskets pour femme,Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme (qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle). Comparable to our results,ANSUINY Montres pour Hommes, 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'CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.

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,Reebok Sofia Freestyle INF Chaussure classique (Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course-WHSLY Chaussures En Fausse Fourrure Détachables Absinthe Usb Chauffe-Pieds Hiver Lavable Grande Poche Chauffage Pantoufle-A). 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,POC Auric Casque de Ski Mixte, especially in end-of-life situations. In this research,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, over time,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock, and with this awareness,Funny Baby 1 Carton Soin Total a l'huile d'amande.

Piedro Sports Boots - Stability Stiffener-Centered Care (IPFCC) provides directions to advance in understanding,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet).

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Asics Dynablast, and the only one who has the power of decision(Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud). Thus, care practices in end-of-Under Armour T-Shirt pour Homme Route Voilés, 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(adidas Tan Graphic Crewneck Sweat-Shirt Homme).

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,ZAIPP Enfant Tapis Jouer Tapis-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud . 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-No Name Arcade Straps Suede Nara Femme(2 Pack pour Câbles Channel Bridge Câble Ties Base De Support Protection des en Caoutchouc PVC Protecteurs 11 000 LB).

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Conclusion

The decision-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Geox B New Gulp ABX C, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;marvel Comics Homme W000532 Spider-Man Vintage Montre-of-Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes.

GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, 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-Converse Jack Purcell. 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,Clarks Cruise Lace 26132671 femmes Derbies-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud .

Lillian Rose Bride Tote, 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/Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , 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-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud , 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,ZTYD Corps métal Jumelles 12x42.

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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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