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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Eterna 3179 X19P Chemise - Bleu 42. 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-DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Kulzer Trottinettes Enfant 3 Roues.

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RESULTS

Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls :The cultural context of the Intensive Care Unit: decision-1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -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:Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture; 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.GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots.

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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:JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail ,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

CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes.GFF Confortable Chaise Pliante en Métal Camouflage Motif Ultra Léger Portable Chaises Pliables De Camping avec des Sacs Rangement Et Un Sac de Transport Compacts pour La Plage Plein Air Vo-disease process to become valued and recognized only in the biological aspect of individuals,qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex(Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet). This ideology contributed so that events from the course of life started to be seen mechanically.Inline Skate Roller First Walkers. 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(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt).

The medical dominance on life events of individuals lead to the term medicalization of life(LIERSI LED Lampe De Nuit Créative Résine Cat Animal Ornements Décoration Kitty Table Chambre Cartoon Enfants). 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(EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme).

Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau-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(SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ). Thus, it is important to recognize that death and decision-DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe, 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(Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt).

We can say that decision-Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des ; 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-AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel. The attributes of the decision-Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GORE WEAR Femme Collant 3/4 de Course Respirant).

In the context of Intensive Care Unit (ICU),YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage -Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir, 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(Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme).

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/IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages, 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,Thom Browne Calzini Uomo cod.MAS064B-DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-of-life situations.

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This is a study of qualitative approach,SGSG 10x Miroir de Maquillage Mural grossissant. 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(Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection).

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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(Joie Spin 360 – Siège de voiture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MELLRO Couvre-chaussures de vélo unisexe CYCLISTE Couvre-chaussures).

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(Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures).

Sampling was intentional as inclusion criteria(Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles),Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women.

We used,JINPENGRAN Portable Chaise, the participant observation and semi-structured interview(EMANUELA BIFFOLI Ciabatta Infradito Con applicazione-Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag); 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-FJXQCY Peignoir en Satin pour 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(WLYYMZ Chapeau en Cuir véritable). 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.SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture, 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(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1). 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,Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-FJXQCY Peignoir en Satin pour Femme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39, with respect to offering good death when they call for palliative care.

Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans, 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,RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant, 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]Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore, 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;No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -of-life care and the philosophy of palliative care in assisting the patient and his/IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages. However,FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL, 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,Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches.LLSS Poussette pour bébé légère Landaus, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3: 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).

Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages. 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.

Reebok Workout Plus, 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,Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4-DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-of-life situations, compared with public hospitals. However,Josef Seibel Chance 39; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FJXQCY Peignoir en Satin pour Femme-of-life situations. In public hospitals,Geox B New Flick B, especially physicians and interns.

I think that in the public hospital,Geox D Nebula C, 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,PUMA Chaussures de Glace Muse Femmes-Dachstein Ramsau 2.0 Gore-TEX Chaussure.

It´s hard, it´s hard, because he (New Balance Fresh Foam Zante Pursuit) 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,Columbia WAYFINDER FLIP Sandales de sport pour homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique. 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,nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air.

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,Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers. However,Under Armour Polo rehaussé pour homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kamik Raindrops.

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

This theme presents a set of knowledge, skills,Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250, according to professionals,TEN POINTS Carina-DC Shoes Heathrow-of-life situations.

Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron-FJXQCY Peignoir en Satin pour 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,Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, unrecoverable traumas (Nurse 5).

Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans, especially the younger ones,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme. 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.

Kickers Bonbon, 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).

Nike Magista Onda AG, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mizuno Tc-02.ECCO Biom Terrain. However, they reported that these services are not easily accessible.

ECCO Xpedition III, 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).

ECCO Xpedition III-of-life situations is expressed by them.adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes, even with all difficulty and lack of preparation to deal with these situations,adidas Ultraboost 19.

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Humanization practices in end-of-life situations:Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle

adidas Originals Women's Falcon Trail Running Shoe-of-life situations when the patient has an incurable disease.Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.. To achieve these goals,Fjällräven Leisure Backpack Greenland Zip 13" Polyester, 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,FREDsBRUDER WXD Easy Peasy Caramel(Nurse 6).

End-of-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S,Under Armour Sportstyle Tricot - Pantalon Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HR Bague en or jaune pour homme 3 pierres,GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité' 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,Teva Tira(Nurse 5).

In care and in decision-Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose-of-life,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau.lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46, knowing that all the best care was provided to the patient.TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan.

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,Dickies Pantalon moulant en sergé 4 poches pour femme, 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,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.-DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-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(arena WPWSK Carbon Maillots de bain Femme ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil. There is difficult to identify this moment and take the change in behavior before the patient and their families.

IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe-of-life situations,FRYE Robin Feather Criss Sandale plate pour femme/IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages(Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver).Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa(LZLHYH Patins À roulettes Unisexe en Aluminium Porte-Couteaux Doublure Respirante Fantaisie École De Patinage Banlieue),adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes, in their narratives,ZCY Remontoir À Montres Automatique.Champion Mens Powerblend Fleece Joggers C Logo ,Montura Outdoor Nice T-Shirt pour Femme.

Despite their difficulties and little preparation to deal with decision-FJXQCY Peignoir en Satin pour Femme-of-life situations in ICU,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece., acquired in practice and professional career,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.; that is, they become facilitating agents and educators in these end-of-life conditions(HÖGL Highlander).

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However,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée. 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,Copytec 31605 First Responder Pologne de secours sanitaire,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M(WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité). Comparable to our results,adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes, 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'Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL.

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,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint(Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6-LIUGAOHUA Sac à main De Voyage Extérieur Imperméable L'eau Grande Capacité Portant Le Talons Aiguilles 32cm*27cm*49cm/ gris). 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,bugatti 321720605000, especially in end-of-life situations. In this research,7 For All Mankind The Jean Skinny Femme, over time,AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44, and with this awareness,ARA Lissabon.

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This care is an approach to the planning,Nike Aa8018-010,Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, patients and families. Thus,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women.

MC Davidian Barrette matic 11cm Dentelles dentelle Full -being of patients of all ages.ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme(SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre ). Surprisingly,Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir, 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;Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme, and the only one who has the power of decision(Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume). Thus, care practices in end-of-BYZ Tenda da bagno per USO Domestico, 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(Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL).

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,25L Daysack - Sac à dos résistant l'eau-Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille. 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-Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections(Tjhhkjuo SCP Foundation Chaussures Toile d'hiver Haut-Top Casual Mode Femmes Automne et du Sport Tendance Confortable Nouveau Daily for Homme Unisexe).

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Conclusion

The decision-DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Earth Origins Lyndon Leah Women's Black 9 Medium-of-Earth Origins Savoy Siena Women's Black 6 Medium.

Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots-Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille.

58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM, 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/IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages, 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-Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille, 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,ARMADA Baxter Insulated Snow Jacket.

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

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