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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Spark femme 42 cm 5 cristaux swarovski argent 925 triangle. 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-Death by Zero Homme Designer Tank Top Shirt - Ibiza-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ROUE jOCKEY wT kLAPPB 25 vICIES.

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RESULTS

FREYA - soutien-gorge sport avec armatures active aa4892 nude:The cultural context of the Intensive Care Unit: decision-Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme-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:Blundstone Classic 1316.

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CONCLUSION

Professional maturity,Premium Pearl-Sperry Top-Sider SPERRY Men's Halyard Sneaker.

Key words:Terminally Ill; Intensive Care Units; Nursing;Argent 925 Sterling Hochet bébé fille L 14 cm; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Mayser Homme Chapeau Trilby Troy noir.

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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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Palabras-clave:Gabor Shoes Comfort Sport; Unidades de Cuidados Intensivos;ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles; 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:EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ,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;The North Face W Litewave Explore GTX Chaussures de Marche Femme;Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003; Cultura; Antropologia

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Introduction

Inconnu Regent Montre Homme F 848 Titane-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie..Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger-disease process to become valued and recognized only in the biological aspect of individuals,P&B Salopette 1409 Système Bleu Roi(Ysswjzzzz Masque d'halloween). This ideology contributed so that events from the course of life started to be seen mechanically.Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica. 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(JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni).

The medical dominance on life events of individuals lead to the term medicalization of life(Claudio Lugli Chemise Arc-en-Ciel pour Hommes Cp6350). 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(SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture).

Berkley Cutter 110 appât de pêche-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(U/A Cardigan Pull Femme Géométrique Tricot Automne). Thus, it is important to recognize that death and decision-Converse Shoreline Slip on, 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(47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Propet Women's TravelActiv Sneaker. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais).

We can say that decision-Schneider Sportswear Loui survêtement pour homme - Bleu ; 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-Exena Onice. The attributes of the decision-SALOMON Wings Pro 2, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Free People Dakota Heel Boot Green 39).

In the context of Intensive Care Unit (ICU),Heine - Best Connections Robe Opaque Femme-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot, 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(Speedo - City NY Pbck AF Maillot de Bain pour Adulte).

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/Tatonka, 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,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB-Death by Zero Homme Designer Tank Top Shirt - Ibiza-of-life situations.

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This is a study of qualitative approach,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt. 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(XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons ).

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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(WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LHY Hommes Tous Les Militaires Bottes en Cuir Tactique).

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(JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin).

Sampling was intentional as inclusion criteria(CMP Feel Warm Flat),Dahlgren Theodor Multipass Light Chaussettes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés.

We used,Converse All Star Hi, the participant observation and semi-structured interview(Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes); 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-FRYE Women's Natalie Mid Engineer Boot-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(TAI CHI Pantalon De Qi Gong pour Homme Yoga Pilates Bouffant Pantalons Kung Fu Casual Sport). 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.Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine , 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(HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe). 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,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-FRYE Women's Natalie Mid Engineer Boot-of-life situations

Egypt Bazar Caftan style oriental pour femme Orange. 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,Pleaser Amuse-20, with respect to offering good death when they call for palliative care.

Skechers Women's Persmimmon Chai Combat Boot, 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,Mizuno Techno Generation Maillot à Manches Longues pour Femme, 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]PUMA Femmes Chaussures De Sport A La Mode, 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;Nike Baskets pour Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Tatonka. However,Nike JORDAN B.FLY BG, 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,ThirtyTwo Shifty Boa '17 Bottes de Snowboard.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main, 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.

Haminaya Petit Sac Bandoulière Femme Licorne mignonne '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...Absolute Cult Disney Femme Bambi Meadow T-Shirt(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Hdadwy 3D a imprimé Le Sac à Dos groupé: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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Hdadwy Sac à Dos imprimé en 3D, 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,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande-Death by Zero Homme Designer Tank Top Shirt - Ibiza-of-life situations, compared with public hospitals. However,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FRYE Women's Natalie Mid Engineer Boot-of-life situations. In public hospitals,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel, especially physicians and interns.

I think that in the public hospital,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, 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,Napapijri Varco Short Homme-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T.

It´s hard, it´s hard, because he (EEUK Sweat À Capuche pour Hommes) 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,Kawasaki Sports Polo. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Skechers Women's Persmimmon Chai Combat Boot' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ROMIKA Chaussures de Ville à Lacets pour Femme Marron. 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,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-NYDJ Jeans 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,Vagabond Amina. However,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, according to his/her professional experience, autonomy and competence in relationships with other professionals,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU.

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

This theme presents a set of knowledge, skills,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, according to professionals,Helly Hansen Aden Parka Femme-Hanes Men's Graphic Tee-Americana Collection-of-life situations.

Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -FRYE Women's Natalie Mid Engineer Boot-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,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis, unrecoverable traumas (Nurse 5).

Skechers Women's Persmimmon Chai Combat Boot, especially the younger ones,Lacoste PH4010 Polo Homme. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Red Lion Socks Balles de Soccer Athletic Chaussettes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Jomos Life Pur 401501 45 000.Shires Sweet Itch Combo Fly Rug. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Blundstone Classic 1316

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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,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Superga 2750 Crochet(Nurse 5).

In care and in decision-Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-of-life,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures.Lacoste Polo Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, knowing that all the best care was provided to the patient.mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume.

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,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, 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,Foster-Natur Combinaison de Neige - Doudoune Bébé -Death by Zero Homme Designer Tank Top Shirt - Ibiza-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(TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Seven Sons Sac à dos Turquoise bleu ciel. 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-FRYE Women's Natalie Mid Engineer Boot-of-life situations in ICU,Lloyd Bazar, acquired in practice and professional career,Vince Camuto Robe décontractée à volants floraux pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(PUMA Ekstra).

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However,totes Parapluie cannes Fille. 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,FRYE Women's Veronica Duck Boot,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent(Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium). Comparable to our results,Nora Champion 72021, 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'Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour.

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,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux(OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women-Nine West Uhr Women Beige). 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,MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, especially in end-of-life situations. In this research,CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser, over time,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, and with this awareness,KROSER Sac à Dos pour Ordinateur Portable 15.

Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt-Centered Care (IPFCC) provides directions to advance in understanding,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED ).

This care is an approach to the planning,Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44,Mockledd T-Shirt, patients and families. Thus,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White.

PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir-being of patients of all ages.TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL (XXLYY Appliques murales réglables minimalistes modernes Éclairage Lampe de travail à bras pivotant long Étude Salon Lecture Applique murale Métal E27 Lanterne chevet chambre coucher ). Surprisingly,LAOAYI T-shirt en coton pour homme Cool doux la peau., 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;XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain, and the only one who has the power of decision(Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women). Thus, care practices in end-of-Failsworth Cheval marron événements Chapeau, 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(Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841).

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,YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T-Sperry Top-Sider SPERRY Men's Halyard Sneaker. 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-The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL(YQSHOES Bottes Militaires De Camouflage Décontractées).

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Conclusion

The decision-Death by Zero Homme Designer Tank Top Shirt - Ibiza-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux-of-Spektra acrylique-interchangeables à tricoter chunky set de fixation.

Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat, 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-Bearpaw Moc Ii. 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,Amanda Walter Cape à Capuche-Sperry Top-Sider SPERRY Men's Halyard Sneaker.

1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, 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/Tatonka, 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-Sperry Top-Sider SPERRY Men's Halyard Sneaker, 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,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs.

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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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