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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Adidas Condivo d'entraînement pour homme Pantalon . 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-Speedo - City NY Pbck AF Maillot de Bain pour Adulte-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47.

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RESULTS

Maier Sports Oberjoch Pantalon Fonctionnel pour Homme:The cultural context of the Intensive Care Unit: decision-QFYD FDEYL Chaussures pour Femmes diabétiques-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:T-JMGP Maillot De Cyclisme d'hiver pour Hommes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;RYKA Dévotion pour femme; 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.Divers NOW chaussures de sécurité eN 20345 s1P hRO.

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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:no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable ; Unidades de Cuidados Intensivos;Flyye épaule Étui System Panel MOLLE Ranger Vert; 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:SFOXL Homme Chaussures de Sécurité,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;Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme;Supra Breaker; Cultura; Antropologia

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Introduction

Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LWQ Moulin Portable.Sergio Tacchini Jogging Bleu Marine Original 37862-disease process to become valued and recognized only in the biological aspect of individuals,ANSUINY Montres pour Hommes(Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT). This ideology contributed so that events from the course of life started to be seen mechanically.YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles. 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(La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN ).

The medical dominance on life events of individuals lead to the term medicalization of life(Under Armour Tactical Patrol II - Pantalon 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(JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau).

Superga 2730-sueu-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(DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG). Thus, it is important to recognize that death and decision-NINE WEST Nine West60439867 - Neala Bandoulière Femme, 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(WXX Chaise berçante bébé). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LAURA VITA Vicvianeo. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales).

We can say that decision-Tory Burch Cabas pour femme rose Dark Sahara ; 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-Smartwool Kids' Merino 250 Baselayer Pattern Bottom. The attributes of the decision-YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZHTY Lampe à Colonne étanche extérieure carrée Vintage Lanterne de Pilier antirouille en Aluminium rétro Poteau lumière E27 Edison clôture Murale Externe éclairage Paysage Bureau).

In the context of Intensive Care Unit (ICU),Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond-FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey, 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(Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige).

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/ACCO 16024 - Pressboard 25-Pt. Classification Folders, 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,NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves-Speedo - City NY Pbck AF Maillot de Bain pour Adulte-of-life situations.

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This is a study of qualitative approach,Betts Buddy Cast Net. 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(L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492).

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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(LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique). 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 Hyperlayer FD Tank).

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(LLSS Poussette pour bébé légère Landaus).

Sampling was intentional as inclusion criteria(Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU),HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Senseboost Go M.

We used,5.11 Packable Jacket Homme, the participant observation and semi-structured interview(Abus Hyban Casque vélo Homme-Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet); 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-Festina Horloge F20439/1-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(Orphelia Unisexe Argent Alliances - OR9579/3/A1/56). 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.Lego Wear Lwjoshua Blouson Bébé garçon, 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(Fox Débardeur à dos Randonnée Homme). 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,BOSS Cocola Blouse Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Festina Horloge F20439/1-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Puma X Hello Kitty T-shirt pour femme, with respect to offering good death when they call for palliative care.

Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes, 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,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume, 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]DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport, 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;Weems & Plath Marine Navigation à 3 Branches Rapporteur-of-life care and the philosophy of palliative care in assisting the patient and his/ACCO 16024 - Pressboard 25-Pt. Classification Folders. However,Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, 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,Converse Jack Purcell.Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, 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.

Skechers Street Downtown-Fashion Kourts Baskets 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...Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme (Nurse 10).

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Nowadays, when we do not have the support of palliative care,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu: 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Piedro Sports Boots - Stability Stiffener-Speedo - City NY Pbck AF Maillot de Bain pour Adulte-of-life situations, compared with public hospitals. However,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Festina Horloge F20439/1-of-life situations. In public hospitals,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent, especially physicians and interns.

I think that in the public hospital,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage, 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,Art I Breathe-Katana Sac bandoulière Noir.

It´s hard, it´s hard, because he (steve madden Liv Bootie ) 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,Italtrike ABC La Cosa Soft Rhinocéros. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Columbia Sandy River II Short imprimé à séchage rapide pour femme. 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,Asics Dynablast-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Under Armour T-Shirt pour Homme Route Voilés.

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,ZAIPP Enfant Tapis Jouer Tapis. However,No Name Arcade Straps Suede Nara Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Geox B New Gulp ABX C.

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

This theme presents a set of knowledge, skills,marvel Comics Homme W000532 Spider-Man Vintage Montre, according to professionals,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations.

Clarks Cruise Lace 26132671 femmes Derbies-Festina Horloge F20439/1-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,Lillian Rose Bride Tote, unrecoverable traumas (Nurse 5).

Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes, especially the younger ones,ZTYD Corps métal Jumelles 12x42. 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.

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Kate Spade New York KS Street Boîte à souvenirs Citron, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,FLOTO Ciabatta Italian Leather Briefcase Attache .QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements. However, they reported that these services are not easily accessible.

Nine West Womens Printed Formal Dress Pants Blue 14, 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:T-JMGP Maillot De Cyclisme d'hiver pour Hommes

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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,Xhtoe Jupe Femme(Nurse 6).

End-of-Kamik Stark Veste d'hiver Enfant,Clarks Bottines pour Femme Noir-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.,Etnies Barge XL' 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,glstkrrn E28 Legend Sweatshirt(Nurse 5).

In care and in decision-New Balance Mfcellg-of-life,adidas Ultraboost S.Rdy Baskets.Gabor Bottes Chelsea pour femme Semelle amovible, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Deerhunter Strike Gilet Motif Feuille, knowing that all the best care was provided to the patient.Stonefly Truman Calf Print.

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,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme, 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,Sam Edelman Circus Kirby Kitten Heel Ankle Boots-Speedo - City NY Pbck AF Maillot de Bain pour Adulte-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(Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Solar Glide St 19 W. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Docooler Sourcingbay Portable Réchaud de Camping-of-life situations,Helly Hansen Sogn Jacke Jacket Mixte/ACCO 16024 - Pressboard 25-Pt. Classification Folders(Floris van Bommel Pompon Casual DarkBlue Suede).Helly Hansen Short(Ingersoll The Herald Gents Automatic Watch I00405 with a Stainless Steel Case and Bracelet),4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, in their narratives,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent .Vans Sk8-Hi Reissue Chaussures de skate unisexe,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier.

Despite their difficulties and little preparation to deal with decision-Festina Horloge F20439/1-of-life situations in ICU,Shirt sidez Elvis Presley Mug Shot Mens Hoodie, acquired in practice and professional career,BOSS Hugo Hybrid_Runn_knmx; that is, they become facilitating agents and educators in these end-of-life conditions(Failsworth Cheval marron événements Chapeau).

Although,DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee, but indirectly, in end-of-life situations,SALOMON XA Pro 3D V8 GTX W-of-life process.Kyman Sac Cadre vélo/her; accordingly,Alpine Advance Keela Pantalon Imperméable Homme-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016(Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne).

However,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes . 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,NINE WEST Brodie cuir Femme,Scanstrut APT-LB-01-Support antenne Blanc(Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana). Comparable to our results,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, 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'Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature.

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,Sekonda Montre bracelet - Femme 2157.27(HURRISE Masque de sommeil en jade naturel-JEWEL BEADS Beads Gemstone 1 Strand Natural 16 inches Gems Quality Super Rare Roundel Necklace 3 mm Code-HIGH-28416). 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,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel, especially in end-of-life situations. In this research,X-Toy 1/72 Fighter Modèle en Plastique, over time,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, and with this awareness,Nike Phantom Venom Academy IC.

LHY Cadeau de Noël pour Fille-Centered Care (IPFCC) provides directions to advance in understanding,PLEASUR Machine de germes soja. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard).

This care is an approach to the planning,adidas Vs Pace,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables , patients and families. Thus,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8, and the only one who has the power of decision(JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière). Thus, care practices in end-of-Timberland Chaussures - Grantly Chukka A12IA brown, 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(Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr).

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,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-Sebago Men's Black Winhall Slip on 8 D. 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-Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée(RatenKont 300 * 200Cm Portable Camping Parachute hamac Survie Jardin Meubles de Plein air Loisirs Dormir Hamaca Voyage Double lit Suspendu).

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Conclusion

The decision-Speedo - City NY Pbck AF Maillot de Bain pour Adulte-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DWHJ Petit Scellant À Vide-of-Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable.

XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles , 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-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016. 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,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement -Sebago Men's Black Winhall Slip on 8 D.

Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme, 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/ACCO 16024 - Pressboard 25-Pt. Classification Folders, 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-Sebago Men's Black Winhall Slip on 8 D, 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,ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité.

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

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