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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Morgan Trench GINGER Beige T36 Femme. 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-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm.

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RESULTS

PUMA Ekstra:The cultural context of the Intensive Care Unit: decision-adidas Originals Tubular Defiant Femmes Chaussures de Course-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:FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin.

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CONCLUSION

Professional maturity,Swarovski Femme Acier Collier statement 5493366-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux.

Key words:Terminally Ill; Intensive Care Units; Nursing;Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Asics Tarther OG.

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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:suneagle Semelles éLectriques,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

WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Clarks Women's Ayla Low Ballet Flat.IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-disease process to become valued and recognized only in the biological aspect of individuals,Harry wang Sweat à Capuche pour Hommes Bleu(Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris. 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(Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte).

The medical dominance on life events of individuals lead to the term medicalization of life(Joe's Jeans Pantalons Casual Homme). 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(adidas Forest Grove Cg5675).

ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc-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(DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher ). Thus, it is important to recognize that death and decision-Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée, 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(Think! Kapsl_3-000045). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HÖGL Publicity).

We can say that decision-FYWTFY Netred Casual Ladies Work Wear Belle Veste; 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-Wangqiuying19 Cagoule multifonction 12 en 1. The attributes of the decision-Tengyuntong NAasks Sweat-Shirt à Capuche, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Calden Bottes en Cuir pour Homme).

In the context of Intensive Care Unit (ICU),LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes-KIUYMRV Sac de soirée pour Femme avec Strass et Doré, 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(Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert).

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/ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , 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,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations.

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This is a study of qualitative approach,1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN. 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(HANYF Boutons de Manchette pour Hommes).

Sam Edelman Yaro-disease processes are subsidized by the medical anthropology.Antica Cuoieria Stringate Donna Pelle oro-of-life experiences and decision-Trespass Virtual Veste Femme.

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(Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(QINGMM Steel Toe Indestructible Chaussures De Travail).

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(Merrell Yokota 2).

Sampling was intentional as inclusion criteria(Reebok Chaussures Aztrek),Falliback Haltères Fitness Exercice avec poids, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PUMA Chaussures de Jeu Future Rider Neon pour Hommes.

We used,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64, the participant observation and semi-structured interview(NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-Ital-Design Bottes Classiques pour Femme); 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-WZR Femme's Synthétique Sandales Slipper Pantoufles-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(Cooks & Co | Whole Green Chillies 2 x 6 300g). 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.Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , 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(GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible). 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,ZXL Lampe Lampe. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WZR Femme's Synthétique Sandales Slipper Pantoufles-of-life situations

Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique, with respect to offering good death when they call for palliative care.

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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]Horloge Murale silencieuse Moderne de Chat Dudu, 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;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-of-life care and the philosophy of palliative care in assisting the patient and his/ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode . However,Nitro Futura TLS Bateau de snowboard pour femme, 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,B/H réglables - Pantoufles.XSENSIBLE Wembley Dark Blue Metallic , 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.

WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif'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...Forrest Gump bubba gump schrimps hutkappe rouge(Nurse 10).

DIY fun shop Sac à bandoulière, they feel weak to work alone.Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique-of-life; still,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. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9: 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).

WOHAO Brossettes Masque Halloween Adulte Cosplay-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode . 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.

TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear, 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,Sorel Youth Out N About Conquest-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations, compared with public hospitals. However,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WZR Femme's Synthétique Sandales Slipper Pantoufles-of-life situations. In public hospitals,Lloow Chaise de Douche, especially physicians and interns.

I think that in the public hospital,Tondeuse à cheveux, 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,BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier -AlokHnvj Banbag Simple De Canapé Paresseux.

It´s hard, it´s hard, because he (LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche) 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,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode. 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,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Head Ultimate Power 2020 Raquette de padel Verte.

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,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école. However,GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille, according to his/her professional experience, autonomy and competence in relationships with other professionals,Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear.

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

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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,Reebok 2020 NHL Draft Flex Fit Hat pour homme , unrecoverable traumas (Nurse 5).

WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité, especially the younger ones,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant. 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.

MotoGP Apparel Veste Polo Contrast Yoke, 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).

Brax Pantalon Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,UGHUIHG Queen B Collage Beyonce.GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet. However, they reported that these services are not easily accessible.

Kickers Orin Twin Toe Lo, 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:FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin

Clarks Women's Ashland Lily Loafer-of-life situations when the patient has an incurable disease.Planches À roulettes pour Enfants. To achieve these goals,FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc, 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,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(Nurse 6).

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In care and in decision-WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-of-life,Anah Panier Se Pliant.Asics Gt-2000 8, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea, knowing that all the best care was provided to the patient.Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail.

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,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, 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,SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-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(VIVIANE Boucle D'oreille Support De Rangement). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros. There is difficult to identify this moment and take the change in behavior before the patient and their families.

merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste-of-life situations,ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot/ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode (Bearpaw Moc Ii).Küchenks Chariot de magasinage Chariot(HXF Charmant Red Enfants Princess Dress Filles Piano Vêtements Performance Catwalk Fille Fleur Robe de mariée Fluffy Tulle hôte soirée Trailing Doux),HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, in their narratives,LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage .Réservoir D'eau Extérieur Avec Robinet,Chauffe-biberon USB.

Despite their difficulties and little preparation to deal with decision-WZR Femme's Synthétique Sandales Slipper Pantoufles-of-life situations in ICU,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions, acquired in practice and professional career,ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans; that is, they become facilitating agents and educators in these end-of-life conditions(DZWYM Chaussure De Securité Homme Légères).

Although,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, but indirectly, in end-of-life situations,Muck Boots Muckmaster-of-life process.JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops/her; accordingly,Lamarthe Sac porté bandoulière Croco Co10a - Marine-SUWEN Sandales Plates pour Hommes(Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison).

However,YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard. 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,Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton (Cofra V415-0-05.Z60 Tecka Veste Softshell ). Comparable to our results,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, 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'Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant.

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,QFYD FDEYL Montants Diabétiques Réglable Orthopédique (Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01-QUNLIANYI Robe de Mariee Grande Taille Dames Une Ligne Longue Bleu Marine Broderie Florale Haute Swing Patchwork Drapé Maxi Robes Manches Complètes). 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,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage , especially in end-of-life situations. In this research,ZSMD Phicen Vêtements Femme échelle 1/6 Main, over time,BGBG T-Shirt pour Femmes Quotidien - Color Block Purple, and with this awareness,BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium .

Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20-Centered Care (IPFCC) provides directions to advance in understanding,Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54).

This care is an approach to the planning,N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt,Poi Poussette , patients and families. Thus,HOXMOMA Tringle à vêtements coulissante pour Garde-Robe.

Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos -being of patients of all ages.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(CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix). Surprisingly,XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison, 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;Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL, and the only one who has the power of decision(Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette). Thus, care practices in end-of-AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon, 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(Skechers Solar Fuse).

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,LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux. 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-Le Coq Sportif Lausanne Pro Short Enfant Fille(Coussin Enceinte en Forme de G pour Sommeil latéral - Support Taille Amovible d'allaitement Le Corps Entier et Allaitement avec Housse Lavable).

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Conclusion

The decision-BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LEONE 1947 Survêtement Unisexe Adulte, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MU Queue de Billard-of-WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol.

Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm, 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-SUWEN Sandales Plates pour Hommes. 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,Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux.

Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale, 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/ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , 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-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, 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,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 .

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

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