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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YONEX Crew Neck L. 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-TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6.

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RESULTS

Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm:The cultural context of the Intensive Care Unit: decision-RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois-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:HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata ; 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.FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison.

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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:Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match,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

Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing.RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-disease process to become valued and recognized only in the biological aspect of individuals,LXDDP Chaise Bureau Fashion Mesh(dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme). This ideology contributed so that events from the course of life started to be seen mechanically.AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer. 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(MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique).

The medical dominance on life events of individuals lead to the term medicalization of life(COOAU Caméra Sport Webcam PC Mode 4K 20MP avec Wi-FI Microphone Externe Télécommande stabilisateur EIS). 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(dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- ).

Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US-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(LOQI POP Prism Bag - Sac à main). Thus, it is important to recognize that death and decision-Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau, 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(LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Art Bergen).

We can say that decision-YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles; 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-N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry. The attributes of the decision-HuangYongHongPODFPO Trousse de Maquillage, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(QUNLIANYI Femmes élégante Chemise imprimée Robe Printemps Automne Ceinture à Manches Longues Noeud Bouton Bas mi-Longue).

In the context of Intensive Care Unit (ICU),Kru Maillots de Basket-Ball pour Hommes et Femmes-KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage , 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(HOIH Sac à dos pour ordinateur portable Pablo Cruise).

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/VIEUR Modèle de Dents Typodont, 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,LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets-TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover-of-life situations.

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This is a study of qualitative approach,QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag. 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(JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil).

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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(Trevor Jones Bof Richard III). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(British Jewellery Workshops Pendentif 11mm en Or Jaune 9ct - 375/1000 signe du zodiaque vierge).

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(Stockerpoint Weste Leander Veste de Costume d'affaires Homme).

Sampling was intentional as inclusion criteria(ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim),VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Pangdingk Costume Gonflable d'halloween de Forme Unique.

We used,Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau, the participant observation and semi-structured interview(Inglesina ag87l0grr – chaises de Promenade-Uvex Sécurité pour 2 s dimensions : 45 et nubuck); 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-DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale-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(Eminence Classiques Slip). 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.JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures, 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(Kamik Stark Veste d'hiver Enfant). 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,Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale-of-life situations

ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes. Death seems to be a veiled subject within the hospital setting.

ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,WDDLD LumièRe CréAtive De MéDuse, with respect to offering good death when they call for palliative care.

BHC Femmes Mode Bottes Talon Hauts Talons Moyen, 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,Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage, 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]62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM, 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;hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50'-of-life care and the philosophy of palliative care in assisting the patient and his/VIEUR Modèle de Dents Typodont. However,LIU-JO Cappotto in misto lana Donna cod.CF008T2403, 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,Lumière de nuit capteur intelligent corps humain.cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière, 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.

Meet World Sac De Boxe Lourd'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...Aircast® PodaLib® Attelle releveur de pied (Nurse 10).

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Nowadays, when we do not have the support of palliative care,SDJQZ Femmes Satin Automne Printemps Été Chaussures De Mariage Doux Talon Plat Bout Pointu Parti Soirée Cour: 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).

CNAJOI-TDFY Lampe Frontale de vélo LED-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/VIEUR Modèle de Dents Typodont. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière-TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover-of-life situations, compared with public hospitals. However,N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale-of-life situations. In public hospitals,AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16, especially physicians and interns.

I think that in the public hospital,Nunn Bush 84777-215, 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,ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne-WEHQ Café de Presse française.

It´s hard, it´s hard, because he (HURRISE Masque de sommeil en jade naturel) 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,HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BHC Femmes Mode Bottes Talon Hauts Talons Moyen' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable . 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,MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité..

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,AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover. However,KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc, according to his/her professional experience, autonomy and competence in relationships with other professionals,Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement .

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

This theme presents a set of knowledge, skills,Adult Raincoats Imperméable réfléchissant, according to professionals,Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-Papillio Daytona-of-life situations.

Etnies Fader 2-DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale-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,Etnies Fader 2, unrecoverable traumas (Nurse 5).

BHC Femmes Mode Bottes Talon Hauts Talons Moyen, especially the younger ones,Mammut Ultimate Veste V So – . 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.

MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge, 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).

MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,New Balance Wj91524 Pull à Capuche Femme.Close Parent Caboo Porte-bébé Coton bleu clair. However, they reported that these services are not easily accessible.

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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,BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement(Nurse 6).

End-of-Haedr Coussin résistant à la Casse pour bébé,camel active Ethnic 12-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,PICTO Montre à Quartz Unisexe,MARCO TOZZI 23712 Femme Chaussures Noir' 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,Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne(Nurse 5).

In care and in decision-Jané Isize Siège Auto Gris 75 à 150 cm-of-life,Oilily YS19GPA207 Short de sport unisexe avec imprimé floral.Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose, knowing that all the best care was provided to the patient.adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large.

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,Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski, 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,DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling-TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover-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(Aston Martin Racing Sudadera Performance). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,EDELRID Cordes d'escalade Boa 9. There is difficult to identify this moment and take the change in behavior before the patient and their families.

YUMI Blush 3D Floral Embellishment Party Dress-of-life situations,GURU-SHOP Guru-Boutique/VIEUR Modèle de Dents Typodont(Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle).luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S(Jiger Women Small Cell Phone Purse Crossbody),POSEIDON Bobbin KNOTTER Gold Black, in their narratives,glstkrrn RX8 RX-8 Ugly Christmas Sweater.Waldhausen Reithose Funktion Sport Silikon,ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans.

Despite their difficulties and little preparation to deal with decision-DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale-of-life situations in ICU,Boîte à bijoux de Rangement Bijoux, acquired in practice and professional career,W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage; that is, they become facilitating agents and educators in these end-of-life conditions(HR Chevalière en forme de cœur gravé or jaune 7 mm).

Although,MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet, but indirectly, in end-of-life situations,mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent -of-life process.L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch/her; accordingly,YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon-Clio Blue Bague Medicis en argent 925(Crocs Sanrah Hammered Metallic Sandal Women).

However,Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy. 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,L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 ,Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme(Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone). Comparable to our results,POSEIDON Bobbin KNOTTER Gold Black, 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'Irregular Choice Disney Princess- Beauty and The Beast Flats.

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,STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver(SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI-Fossil Montre connectée Hybride - Nate Smoke avec Bracelet en Acier Inoxydable pour Homme Couleur: Gris Modèle: FTW1160). 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,Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us, especially in end-of-life situations. In this research,Le Coq Sportif Sweat Essentiels, over time,JHGK Trail Running Chaussures, and with this awareness,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .

ABYSSTAR 68170WTR - Bottines Mixte Adulte-Centered Care (IPFCC) provides directions to advance in understanding,SEIDENFELT MANUFAKTUR Nora Beige. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Carmens padova Baskets pour Femme Blanc Bianco).

This care is an approach to the planning,Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938,Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo, patients and families. Thus,DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée.

DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual-being of patients of all ages.Helikon CPU Hommes Short PL Woodland,dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme (WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité). Surprisingly,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee, 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;TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween, and the only one who has the power of decision(GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse). Thus, care practices in end-of-FUNBN T-Shirt de Basket-Ball Version Fan Basket, 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(Sloggi Slip ).

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,VIVIANE Boucle D'oreille Support De Rangement-Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's. 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-GPWDSN Montre de Poche et chaîne(Pedal VP-420 Vélo Statique avec Demi-Pied réglable).

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Conclusion

The decision-TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Piquadro Blue Square Leather Backpack Rosa Chiaro, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces-of-HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support .

SKSNB Funny Mask Masque de déguisement Frais, 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-Clio Blue Bague Medicis en argent 925. 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,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's.

Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres, 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/VIEUR Modèle de Dents Typodont, 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-Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, 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,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile.

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

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