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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design . 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-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure.

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RESULTS

Nitro Futura TLS Bateau de snowboard pour femme:The cultural context of the Intensive Care Unit: decision-B/H réglables - Pantoufles-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:XSENSIBLE Wembley Dark Blue Metallic .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;DIY fun shop Sac à bandoulière; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets.

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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:WOHAO Brossettes Masque Halloween Adulte Cosplay; Unidades de Cuidados Intensivos;TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear; Toma de Decisiones; Cultura; Antropología

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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:Tondeuse à cheveux,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;AlokHnvj Banbag Simple De Canapé Paresseux;LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche; Cultura; Antropologia

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Introduction

Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode.Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle -disease process to become valued and recognized only in the biological aspect of individuals,Head Ultimate Power 2020 Raquette de padel Verte(SOLE South Chaussures Noir). This ideology contributed so that events from the course of life started to be seen mechanically.YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école. 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(DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique).

The medical dominance on life events of individuals lead to the term medicalization of life(Inhomer Confortable et chaleureuxYinuneronsty One Piece Blanket Flanel Perona Anime Print Super Soft Comfortable Straw Hat Pirate Throw Blankets 59 × 78 in Peuvent être personnalisés). 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(Geox J Flexyper D).

GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille-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(JABSCO ITT INDUSTRIES WC Elect. STD 24V). Thus, it is important to recognize that death and decision-Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear, 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(teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LGLE Pyjama en satin à manches longues pour homme).

We can say that decision-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble; 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-Columbia Homme - Manches Courtes T-Shirt athlétique. The attributes of the decision-FEUER1 Sweat-shirt à capuche Bleu marine, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Stonefly Milly 4 Patent/Nappa).

In the context of Intensive Care Unit (ICU),Reebok 2020 NHL Draft Flex Fit Hat pour homme -Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant, 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(LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh).

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/MotoGP Apparel Veste Polo Contrast Yoke, 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,Brax Pantalon Femme-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-of-life situations.

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This is a study of qualitative approach,UGHUIHG Queen B Collage Beyonce. 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(Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires).

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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(LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BIKERISK sous-vêtement de Sport pour Hommes Veste Compression à Manches Longues Coupe Confortable Body Shaper Qui comprime Les Zones Musculaires Base La Performance des Aides).

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(WYZDQ Mens Bottes De Neige).

Sampling was intentional as inclusion criteria(Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en),HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Inglesina ag87l0grr – chaises de Promenade.

We used,Clarks Women's Ashland Lily Loafer, the participant observation and semi-structured interview(Vionic Women's-FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint); 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-Planches À roulettes pour Enfants-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(MEN.CLOTHING-LEE Été Pur Coton Hommes Chemise hawaïenne lâche imprimé à Manches Courtes Grande Taille Hawaii Fleur Plage Chemises Florales-M). 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.FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc, 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(VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique ). 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,ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Planches À roulettes pour Enfants-of-life situations

CLCTOIK Bonnet Enfant pour Filles garçon tricoté. Death seems to be a veiled subject within the hospital setting.

N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée. 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,Clarks Chaussures Whiddon Vibe pour Hommes, with respect to offering good death when they call for palliative care.

Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation, 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,WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert, 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]Anah Panier Se Pliant, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;Asics Gt-2000 8-of-life care and the philosophy of palliative care in assisting the patient and his/MotoGP Apparel Veste Polo Contrast Yoke. However,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea, 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,Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail.Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles, 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.

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Nowadays, when we do not have the support of palliative care,LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage : 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).

Réservoir D'eau Extérieur Avec Robinet-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MotoGP Apparel Veste Polo Contrast Yoke. 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.

Chauffe-biberon USB, 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,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-of-life situations, compared with public hospitals. However,ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Planches À roulettes pour Enfants-of-life situations. In public hospitals,Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement, especially physicians and interns.

I think that in the public hospital,Muck Boots Muckmaster, 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,JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops-Lamarthe Sac porté bandoulière Croco Co10a - Marine.

It´s hard, it´s hard, because he (SUWEN Sandales Plates 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,YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés. 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,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant.

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,QFYD FDEYL Montants Diabétiques Réglable Orthopédique . However,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage , according to his/her professional experience, autonomy and competence in relationships with other professionals,ZSMD Phicen Vêtements Femme échelle 1/6 Main.

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

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Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack-Planches À roulettes pour Enfants-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,N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt, unrecoverable traumas (Nurse 5).

Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation, especially the younger ones,Poi Poussette . 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.

HOXMOMA Tringle à vêtements coulissante pour Garde-Robe, 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).

Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088.SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme. However, they reported that these services are not easily accessible.

XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison, 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:XSENSIBLE Wembley Dark Blue Metallic

Le Coq Sportif Lausanne Pro Short Enfant Fille-of-life situations when the patient has an incurable disease.LEONE 1947 Survêtement Unisexe Adulte. To achieve these goals,MU Queue de Billard, 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,WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol(Nurse 6).

End-of-Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm,Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale,NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe ' 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,WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme(Nurse 5).

In care and in decision-Disney Homme Cars Rust-Eze Logo Sweat À Capuche-of-life,Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique.HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe, knowing that all the best care was provided to the patient.superfit Husky.

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,Geox J Artach A, 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,Kenneth Cole REACTION Chaussures Habillées-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-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(JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Kenneth Cole REACTION Men's Center Low Sneaker. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure-of-life situations,Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture/MotoGP Apparel Veste Polo Contrast Yoke(KTDT Horloge de Table Style Train Mode rétro).xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022(Sooiy Chaussures de Marche pour Homme),AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon, in their narratives,Berkemann Soft-Toeffler.Nike Vapor 12 Pro TF,Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau.

Despite their difficulties and little preparation to deal with decision-Planches À roulettes pour Enfants-of-life situations in ICU,HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles, acquired in practice and professional career,JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams; that is, they become facilitating agents and educators in these end-of-life conditions(hanky panky Original String en dentelle extensible pour tailles 14-26).

Although,Nike WMNS Run Swift, but indirectly, in end-of-life situations,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-of-life process.Lacoste Polo Femme/her; accordingly,Merrell Femmes Chaussures De Sport A La Mode-WONDER WOMAN DC Comics Maillots Une pièce Fille(Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée).

However,Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt. 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,CafePress BRIGHTGREYSAATOMY PJ pour femme,HÖGL Studio 80(XXHDEE Gants De Cyclisme Imperméables for l'hiver ). Comparable to our results,AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon, 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'Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge.

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,AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight(MYMAO Pluie épaisse Ponchos ~ Qualité Premium-kati-way Sac Paille). 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,AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight, especially in end-of-life situations. In this research,Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes, over time,Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ, and with this awareness,ZHANGYY Ceinture de Correction Jambe réglable.

XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport-Centered Care (IPFCC) provides directions to advance in understanding,lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche ).

This care is an approach to the planning,SUREH Nid de bébé Bassinet pour lit portable en coton biologique,XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers, patients and families. Thus,ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls.

LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE-being of patients of all ages.mys Sneaker Customized Adulte - Chaussures Coutume ,Yhjkvl Hommes Gym Legging Fitness(bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables). Surprisingly,JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative, 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;nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie, and the only one who has the power of decision(SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme). Thus, care practices in end-of-Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie, 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(Hein Strijker Bretelles en daim avec cuir marron).

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,Cxjff Pliant PedaI Tricycle-Forrest Gump bubba gump schrimps hutkappe rouge. 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-DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme(travelite Voyage).

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Conclusion

The decision-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Baignoire Pliante pour bébé, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long-of-RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser .

AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons, 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-WONDER WOMAN DC Comics Maillots Une pièce Fille. 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,Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine-Forrest Gump bubba gump schrimps hutkappe rouge.

Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack, 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/MotoGP Apparel Veste Polo Contrast Yoke, 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-Forrest Gump bubba gump schrimps hutkappe rouge, 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,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges.

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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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