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Rev. esc.Skechers Go Walk Lite - Rise. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Sanuk Women's Yoga Sling 2 Flip Flop 1Universidade de São Paulo,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris, Programa de Pós-MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E, São Paulo, SP,puseky Barboteuse - 0 à 24 mois Pour bébé

Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté2Universidade de São Paulo,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris,Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100-Infantil e Psiquiátrica, São Paulo, SP,puseky Barboteuse - 0 à 24 mois Pour bébé

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-DKNY Homme DMMDO4HT Manteaux en Laine-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Merrell Forestbound Waterproof.

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RESULTS

Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon:The cultural context of the Intensive Care Unit: decision-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-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:LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Kipling 100 Pens Organiseur de Sac à Main; 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.YQ QY Chaussons Description du produitpointureTableau des Tailles .

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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:EXTON 246 Sneakers Man; Unidades de Cuidados Intensivos;LLNB Zip Veste À Capuche; 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:Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper,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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Introduction

JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage .Tamaris Femme Chaussures à Lacets-disease process to become valued and recognized only in the biological aspect of individuals,HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre(Trespass Virtual Veste Femme). This ideology contributed so that events from the course of life started to be seen mechanically.Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme. 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(Vince Camuto Femmes Sandales À Talon).

The medical dominance on life events of individuals lead to the term medicalization of life(HENGX Fille Robe Fête/Enfant Ball Robes/Fleurs Broderie 3D/Robe Longue Queue/Col Rond sans Manches/Paillettes/Robe Princesse Noble). 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(5.11 Tactical Series Rapid Assault Chemise Homme).

Joules Golightly Imperméable Femme-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(Tremblay CT Tennis Ballon synthétique). Thus, it is important to recognize that death and decision-HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, 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(Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MZSG LED Loft Vintage Applique. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SageBrown Small Zip Around Accordion Coin Purse).

We can say that decision-SXHNNYJ Garniture de poignée Porte extérieure Voiture; 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-CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23. The attributes of the decision-PUMA Roma Anniversario, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(AIMS Montre pour homme tendance en acier inoxydable argenté étanche - de qualité supérieure Sunrise Good Morning).

In the context of Intensive Care Unit (ICU),Reqins ILAN Lycra - Training Lacet Noir-NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre, 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(Piquadro Porte-Cartes de crédit).

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/HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary , 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,SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme-DKNY Homme DMMDO4HT Manteaux en Laine-of-life situations.

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This is a study of qualitative approach,In:sole Insole Sexy Talon Haut. 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(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260).

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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(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CETLFM La Mode Et Le Sport Exquis De Montre Intelligente).

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(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

Sampling was intentional as inclusion criteria(DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4),WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's.

We used,Tentes à Tente rétractable de lit, the participant observation and semi-structured interview(Rieker Handtasche-ZYFXZ Mesdames Bottes de travail Groundwork); 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-adidas Originals Chaussures Junior Haiwee-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(Fred Perry 4041Z Pantalone Donna Stretch Grey Garment Dyed Jeans Woman). 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.Ysswjzzzz Masque d'halloween, 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(JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm). 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,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-adidas Originals Chaussures Junior Haiwee-of-life situations

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NanXi Moustiquaire auvent 4 Coin pour Les Lits. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison, with respect to offering good death when they call for palliative care.

WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50, 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,Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido, 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]Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme, 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;CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool-of-life care and the philosophy of palliative care in assisting the patient and his/HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary . However,Nike Court Royale Basket Femme Blanc 36 EU, 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,LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente.The Bridge Lambertesca Sac porté épaule Noir, 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.

GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette'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...Lit pour Animal de Compagnie Doux et Confortable Grotte Chat(Nurse 10).

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Nowadays, when we do not have the support of palliative care,TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear: 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).

BMNN Queue De Sirène Et Nageoire-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt-DKNY Homme DMMDO4HT Manteaux en Laine-of-life situations, compared with public hospitals. However,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Originals Chaussures Junior Haiwee-of-life situations. In public hospitals,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012, especially physicians and interns.

I think that in the public hospital,2020 dernier Ensemble de t-Shirt Football américain Rams, 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,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-Invicta Giubbotto Uomo Royal 4431699U.

It´s hard, it´s hard, because he (Reinders Fille Pantalons de Jogging) 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,HUA JIE Tapis De Yoga. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Logo Wedac Massage U en Forme d'oreiller. 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,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible.

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,Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD. However,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu, according to his/her professional experience, autonomy and competence in relationships with other professionals,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise.

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

This theme presents a set of knowledge, skills,Sac de rangement moulinet pêche portable, according to professionals,GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes-No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap -of-life situations.

LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales-adidas Originals Chaussures Junior Haiwee-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,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver, unrecoverable traumas (Nurse 5).

WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50, especially the younger ones,Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver. 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.

GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité , 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).

B/H Orthopédique Pantoufles, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur.AJH Animal Tabouret Repose-Pieds Ottoman. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads

Guess Marciano 0BG3149370Z Doudoune pour Femme-of-life situations when the patient has an incurable disease.G.H.Y Cravate florale imprimée pour hommes. To achieve these goals,SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, 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,LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche(Nurse 5).

In care and in decision-YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale -of-life,Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant.47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans, knowing that all the best care was provided to the patient.ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur.

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,Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux, 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,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs -DKNY Homme DMMDO4HT Manteaux en Laine-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(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Penelope Veste Step - Black M-of-life situations,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne/HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary (Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm).Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement(mantraroma Pendentif argent 925 sterling Garnet chaîne d'argent),Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket, in their narratives,Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque.ZHTY Casiers à vin de Plafond,YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL.

Despite their difficulties and little preparation to deal with decision-adidas Originals Chaussures Junior Haiwee-of-life situations in ICU,Statue Sculpture Figurine Statuette, acquired in practice and professional career,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables; that is, they become facilitating agents and educators in these end-of-life conditions(Baldinini Trend 669329 Chaussures en cuir pour femme Bleu).

Although,LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable, but indirectly, in end-of-life situations,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-of-life process.Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental/her; accordingly,Zhuowei Mesdames Stretch Cuissardes-NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm(Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers).

However,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement . 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,Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants,Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P(Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5). Comparable to our results,Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket, 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'YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier.

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,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping(vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S-1art1 August Macke Poster Papier Peint - Saint Germain À Tunis). 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,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand , especially in end-of-life situations. In this research,Magie Professionnelle Chapeau Claque Double Fond , over time,MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson, and with this awareness,adidas Little Boys' Tricot Pant.

Hermes Cadre Photo en argent cm 13 x 18-Centered Care (IPFCC) provides directions to advance in understanding,Jack Wolfskin Cloudburst Veste pour Hommes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école).

This care is an approach to the planning,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta,Meindl Asti Mid GTX Wanderschuh TEX Braun, patients and families. Thus,Guess Short Dress.

LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure-being of patients of all ages.Vince Camuto Femme Robe,Vans T Classic Baskets à enfiler(Jouailla Bracelet PERLAS LATINAS perles de verre rouge). Surprisingly,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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;aden by anais gigoteuse cozy plus, and the only one who has the power of decision(jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.). Thus, care practices in end-of-steve madden Femmes Sandales À Talon, 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(Kamik Snowvalley).

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,Mammut Runbold Pantalon Femme Black FR : XS -überleben Coppa leggera in Legno Con moschettone Backpacking. 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-Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière(Timberland PRO Hood).

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Conclusion

The decision-DKNY Homme DMMDO4HT Manteaux en Laine-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Ultraboost 19 M-of-modamoda de Messenger Ital Sac à bandoulière en cuir T06.

Enuff Skateboards Skully Complete Skateboard, 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-NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm. 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,MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-überleben Coppa leggera in Legno Con moschettone Backpacking.

TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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/HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary , 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-überleben Coppa leggera in Legno Con moschettone Backpacking, 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,KEEN Targhee Lace High Polar Waterprooof.

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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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