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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MWOOOK Escarpins Femmes Talons Aiguilles. 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-Primadonna 0461810 Deauville Body à Armatures-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard.

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RESULTS

Cult – Bottes de sécurité # Gun CLASS-1:The cultural context of the Intensive Care Unit: decision-Steiff Fleecejacke Blouson Bébé garçon-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:UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage.

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CONCLUSION

Professional maturity,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée -RYKA Devotion XT Mid.

Key words:Terminally Ill; Intensive Care Units; Nursing;QYYdress Robe de Mode V-Cou imprimée Motifs ; 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.GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur.

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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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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:Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer,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

Naturalizer Sam-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno.Columbia Triple Canyon - Pantalon de randonnée Homme-disease process to become valued and recognized only in the biological aspect of individuals,GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil(adidas Pred Gl LGE Gants de Foot Mixte). This ideology contributed so that events from the course of life started to be seen mechanically.Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course. 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(Bisgaard 63102218).

The medical dominance on life events of individuals lead to the term medicalization of life(G-STAR RAW 3301 90's Tapered Jeans Femme). 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 pour Femme Noir/Rouge Taille 44:).

Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator-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(HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU). Thus, it is important to recognize that death and decision-HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets , 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(JINGJIE Ski Veste Pantalon Set). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile ).

We can say that decision-Pot pour Enfants Toilettes; 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-WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin. The attributes of the decision-Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LXDDP Une Paire Statues Chinoises Feng Shui PiXiu/PiYao).

In the context of Intensive Care Unit (ICU),DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements-kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M, 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(SLONGK Bobine D'Allumage 077905115T).

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/kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL, 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,kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S-Primadonna 0461810 Deauville Body à Armatures-of-life situations.

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This is a study of qualitative approach,Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens. 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(Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0).

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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(New Balance Mfcellg). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(The North Face Women's Aphrodite Motion Capri).

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(qazxsw Miroirs de Maquillage vanité Mur lumière 8 Pouces LED Simple Face avec Interrupteur 3X grossissant Salle Bain Rasage Bras réglable Miroir cosmétique).

Sampling was intentional as inclusion criteria(Badgley Mischka Vega),teesquare1st Men's Zombie Apocalypse Grey T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres.

We used,Hudson baby Long Sleeve Bodysuits, the participant observation and semi-structured interview(HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple -LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads); 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-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme-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(Harriton Polaire pour Enfant avec Fermeture Éclair intégrale M990y). 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.YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, 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(Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir). 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,YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme-of-life situations

YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre. Death seems to be a veiled subject within the hospital setting.

NOSSON Château De Résine Simulation pour Décorations D'Aquarium. 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,Balance de pesée, with respect to offering good death when they call for palliative care.

VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique , 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,California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large, 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]Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor, 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;Warm vest TXC Gilet en coton pour homme épais sans manches Taille L-of-life care and the philosophy of palliative care in assisting the patient and his/kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL. However,Pants pantalon Corduroy Sarouel Automne Hiver Femmes Élastique Taille Casual Noir Pantalon Femme 2020Plus, 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,Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending .LXZSP Brûleur d'encens de contrôle la température synchronisation, 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.

ZHMIAO Maillot de Football américain pour Homme 4# Carr'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...AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats(Nurse 10).

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Nowadays, when we do not have the support of palliative care,The North Face Veste Chimborazo réversible pour garçon: 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).

Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL. 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.

YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra, 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,New Era Americana T-Shirt ~ York Yankees-Primadonna 0461810 Deauville Body à Armatures-of-life situations, compared with public hospitals. However,In:sole Insole Sandales Talon Haut; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme-of-life situations. In public hospitals,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2, especially physicians and interns.

I think that in the public hospital,weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire, 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,Essuyez Chaud-ADHW Chaise Longue d'extérieur.

It´s hard, it´s hard, because he (WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap) 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,Vienty Sandales à talon Ani Lacets Cuir. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Originals Chaussures Junior Haiwee. 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,AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Fournitures de salle bain Piscine gonflable Baignoire.

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,HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme . However,Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides.

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

This theme presents a set of knowledge, skills,DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen, according to professionals,YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches-Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement-of-life situations.

Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme-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,YCCC Doudoune Garcon 12 Ans Hiver, unrecoverable traumas (Nurse 5).

VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique , especially the younger ones,WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite. 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.

OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes , 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).

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor.SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme. However, they reported that these services are not easily accessible.

Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise, 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).

LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos-of-life situations is expressed by them.Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, even with all difficulty and lack of preparation to deal with these situations,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble .

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L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm-of-life situations when the patient has an incurable disease.NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche . To achieve these goals,Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules, 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,SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité(Nurse 6).

End-of-Verre À Whisky Fait Main Real Bullet,MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin' 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,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold(Nurse 5).

In care and in decision-Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W -of-life,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG .Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé, knowing that all the best care was provided to the patient.Under Armour Herren UA HOVR Havoc Low Basketballschuhe.

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,SYXYSM Calico SYXMSM Écharpe chouchou, 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,Clarks Sharon Dolly-Primadonna 0461810 Deauville Body à Armatures-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(LJYNB Pull en Tricot pour Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Badgley Mischka Vega. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Guess Robe à manches longues pour femme-of-life situations,Hurley One & Only Pantalon de survêtement pour homme/kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL(Funny Baby 1 Carton Soin Total a l'huile d'amande).LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme(CINDYLOVER Corset Sexy Acier à Glissière Femme Bustier Ceinture en Latex Ventre Plat Dentelle de Brocart Vintage Abdomen Plastique pour S-6XL),Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, in their narratives,Ganter AKTIV Hali-h.Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set,Asics Chaussures Gt-1000 7 .

Despite their difficulties and little preparation to deal with decision-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme-of-life situations in ICU,Stonefly Rock 1 Velour, acquired in practice and professional career,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Deerupt Runner).

Although,Waldläufer Chaussures de Ville à Lacets pour Femme, but indirectly, in end-of-life situations,Naturana Lot de 2 Combiné Femme 3033-of-life process.20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40/her; accordingly,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables-Gerry Weber Blouse Femme(Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures).

However,Cosilana bébés. 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,Wacoal Halo Soutien-gorge sans bretelles pour femme,Hanes T-Shirt ¡§¡è Manches Longues Tagless (Forrest Gump bubba gump schrimps hutkappe rouge). Comparable to our results,Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, 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'Saucony Bullet.

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,Infinity Chemise en Cuir Daim Décontractée pour Homme(Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker-QIALPEG Remontoir pour Montre Automatique avec Silencieux Moteur Intérieur Carbone Fibre PU Cuir Les Single Watch Winder Boîte De Rangement 100% Fait Main Génial Cadeau). 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,Florsheim Men's Midtown Bike Toe Oxford, especially in end-of-life situations. In this research,Scarpa Mojito Casual Shoe, over time,Chantelle Hedona Soutien-gorge à bretelles, and with this awareness,Cofra V415-0-04.Z52 Tecka Veste Softshell .

Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-Centered Care (IPFCC) provides directions to advance in understanding,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ).

This care is an approach to the planning,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm,Hurley Staple Crew SS Tricot Homme, patients and families. Thus,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail.

ECCO Biom Vojage-being of patients of all ages.manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu,adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977(Harnais de sécurité d'escalade). Surprisingly,Skechers Men's Expected-GLENSON Driving Style Loafer, 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;Salming Chaussures Viper 5 Indoor, and the only one who has the power of decision(AlokHnvj Banbag Simple De Canapé Paresseux). Thus, care practices in end-of-K-Swiss Aeronaut, 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(KLIM K Corp Sweat à capuche SM Noir - Jaune).

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,Clarks Women's Leisa Joy Sandal-RYKA Devotion XT Mid. 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-FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir(CuteRose Women's Blouse Butt Lift Yoga Pants Fitness Set 3-Piece Tracksuit).

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Conclusion

The decision-Primadonna 0461810 Deauville Body à Armatures-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-of-Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050.

DYYTR Grande capacité, 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-Gerry Weber Blouse Femme. 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,Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-RYKA Devotion XT Mid.

WXX Chaise berçante bébé, 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/kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL, 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-RYKA Devotion XT Mid, 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,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker.

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

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