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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Helikon CPU Hommes Short PL Woodland. 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-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support .

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RESULTS

SKSNB Funny Mask Masque de déguisement Frais:The cultural context of the Intensive Care Unit: decision-JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-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:Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer; 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.Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D .

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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:LIMQ Lingerie en Peluche Babydoll; Unidades de Cuidados Intensivos;Certified Freak Hail Santa Gym White; 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:Timberland Splitrock 2,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;ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men;Visit the Carhartt Store Wip Car-Lux Jacket Homme; Cultura; Antropologia

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Introduction

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe.adidas Femmes Chaussures Athlétiques-disease process to become valued and recognized only in the biological aspect of individuals,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant(Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair). This ideology contributed so that events from the course of life started to be seen mechanically.FERRINO ZAINO Core 30 Nero Trekking. 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(PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade).

The medical dominance on life events of individuals lead to the term medicalization of life(Pinkkart Saree Sari en Soie Blanche pour Femme - Style Indien Ethnique). 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(STANTEKS Maillot de Bain Bleu/Jaune Taille : 44).

2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de 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(PUMA Style Rider Ride on). Thus, it is important to recognize that death and decision-MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal, 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(Mizuno Wave Mirage 2.1). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements).

We can say that decision-Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles; 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-Clarks Women's Juliet Rose Loafer. The attributes of the decision-W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Unisexe Gants de Boxe).

In the context of Intensive Care Unit (ICU),ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage-Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme, 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(Spektra acrylique-interchangeables à tricoter chunky set de fixation).

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/adidas Forest Grove, 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,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations.

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This is a study of qualitative approach,PUMA Alee Gore-Tex Mens Performance Bottes de Voile. 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(NYLY Sac à Dos Harry P).

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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(Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MKJYDM Personnalité de Jeune Fille garçon débutant Belle personnalité Scooter à Quatre Roues Skateboard facultatif Planche Roulette).

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(HHORD Panier De Bicyclette Rétro Tissé D'imitation).

Sampling was intentional as inclusion criteria(ROMIKA Chaussures de Ville à Lacets pour Femme Marron),VearFit Cuir véritable, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Dickies Henley Chemise à manches longues 3 boutons pour femme.

We used,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux , the participant observation and semi-structured interview(PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L-Salamander Vasco); 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-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-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(Puma 10 er Pack Boxer Boxershorts Men Pant Underwear black size L). 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.STAR TREK Sweat à Capuche Jeunesse Tos Episode 31, 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(LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes). 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,ZWF Boots Bottes De Cow-Boy Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small, with respect to offering good death when they call for palliative care.

Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, 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,wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite, 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]wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite, 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;Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Forest Grove. However,hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté, 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,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver.WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , 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.

Lee Petit Pantalon cargo pour femme'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...Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible(Nurse 10).

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Nowadays, when we do not have the support of palliative care,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine: 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).

Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Forest Grove. 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,HJTLK Chariot de magasinage léger 39L-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations, compared with public hospitals. However,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations. In public hospitals,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm, especially physicians and interns.

I think that in the public hospital,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear, 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,Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre.

It´s hard, it´s hard, because he (GBY Maillot de Basket-Ball Heat n ° 3 Wade) 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,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or. 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,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm.

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,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme. However,Kit de douche Bidet Douche musulmane , according to his/her professional experience, autonomy and competence in relationships with other professionals,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable.

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

This theme presents a set of knowledge, skills,Furla Portefeuille en Cuir Babylon S Bi-Fold, according to professionals,adidas Duramo SL-Grunland CI2835 DIRA Ciabatta Donna S.-of-life situations.

Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-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,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, unrecoverable traumas (Nurse 5).

Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, especially the younger ones,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens. 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.

ABAKUHAUS Je t'aime davantage Nappe, 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).

Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,EinStein Bague solitaire en diamant 0.Strele Balançoire Portative Apaisante pour Bébé. However, they reported that these services are not easily accessible.

L@YC Sandales tendance pour femme à talon moyen, 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:Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres

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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,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm (Nurse 6).

End-of-AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode,Ensemble de vadrouille et Seau-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage' 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,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique (Nurse 5).

In care and in decision-Ralph Lauren Pull - Homme-of-life,FRYE FRYE70663 - Billy Shootie Femme.Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, knowing that all the best care was provided to the patient.Under Armour Own The Gym Duffel Sac Mixte Adulte.

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,Kadolis Matelas Landau Latex Blanc, 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,Clair de Lune Doublure en polaire pour couffin osier Rose-Piquadro Blue Square Leather Backpack Rosa Chiaro-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(QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme-of-life situations,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme/adidas Forest Grove(ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43).NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements(Treasu-LQ Bottes tactiques du désert respirantes légères pour hommes et femmes de combat militaires antidérapantes résistantes à l'usure Chaussures randonnée trekking montantes d'extérieur),jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work, in their narratives,hsoazi Latex Panda Mask.WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée,PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade.

Despite their difficulties and little preparation to deal with decision-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations in ICU,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, acquired in practice and professional career,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme; that is, they become facilitating agents and educators in these end-of-life conditions(Meet World Sac De Boxe Lourd).

Although,Jack Wolfskin Whirlwind Veste Homme, but indirectly, in end-of-life situations,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-of-life process.LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux /her; accordingly,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair-ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 (PUMA Nucleus Lux).

However,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri. 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,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc,Hackett London Pantalon Homme(weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire). Comparable to our results,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work, 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'NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott.

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,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume(chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1-WMZQW Chaussure Homme Cuir Angleterre Style Casual Ville À Lacets d'affaires Oxford Business Mariage Mode Habillées Derby Jaune Noir 38-48). 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,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage, especially in end-of-life situations. In this research,Floris van Bommel Belts Gris, over time,PunkFootball Je déteste le T-shirt West Ham United de Millwall, and with this awareness,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's.

Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40-Centered Care (IPFCC) provides directions to advance in understanding,PUMA Veste de Pluie Tabaluga pour Fille. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba).

This care is an approach to the planning,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures,MEETGG Porte-Bébé Multifonctionnel Trois en Un, patients and families. Thus,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire .

Gringo Fairtrade Felt Owl Shoulder Bag-being of patients of all ages.Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière,Npeiyi Seau pour urine féminine(Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA). Surprisingly,Kamay's Kamay’s Boîte de rangement, 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;Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible, and the only one who has the power of decision(Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir). Thus, care practices in end-of-HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, 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(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).

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,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day-Radiateur Électrique - Ventilateur De Chauffage Portable. 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-XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes (Maillot de Football américain pour Homme Alvin Kamara).

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Conclusion

The decision-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince -of-GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble.

Kayak 1/2/3/4 Personne Faisant du Kayak, 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-ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 . 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,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes-Radiateur Électrique - Ventilateur De Chauffage Portable.

LY88 Ouvre-Bouteille électrique, 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/adidas Forest Grove, 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-Radiateur Électrique - Ventilateur De Chauffage Portable, 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,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe.

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Received: January 12, 2015; Accepted: May 05, 2015

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