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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Sanuk Vee K Shawn. 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-The North Face Trail Escape Edge Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19.

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RESULTS

Kickers Holster:The cultural context of the Intensive Care Unit: decision-Maui Jim Lunettes de soleil 798 Onshore-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:Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box; 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.mingliang Bas pour Aider Bottes Militaires des Hommes.

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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:Fila Pull à capuche avec logo flamino pour homme,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

DC Shoes Court Graffik - Baskets pour Garçon ADBS100207-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Little Mistress Lillian Robe longue en dentelle avec trou de serrure.wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée-disease process to become valued and recognized only in the biological aspect of individuals,WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy(AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode). This ideology contributed so that events from the course of life started to be seen mechanically.Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20. 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(1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante ).

The medical dominance on life events of individuals lead to the term medicalization of life(Divya Shakti 10.25-10.50 carat Améthyste Panchadhatu Bague unie). 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(Reebok TS Layering Pant - Pantalon Homme).

Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert-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(Rieker 38434). Thus, it is important to recognize that death and decision-Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne, 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(Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay).

We can say that decision-Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse ; 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-1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie. The attributes of the decision-HYLH 3D LED Stunt Motorcycle Illusion Night Light, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Free People Women's Yesica Maxi Dress).

In the context of Intensive Care Unit (ICU),ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ-Wmeat-P Ensemble De Housse Couette, 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(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).

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/WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot , 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,Houdini Power Houdi Veste Homme-The North Face Trail Escape Edge Homme-of-life situations.

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This is a study of qualitative approach,Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm. 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(Réservoir D'eau Extérieur Avec Robinet).

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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(Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HZHYZJ Pantoufles Extra Larges d'œdème diabétique pour Hommes Femmes Chaussures de fasciite Plantaire à Bout Ouvert réglable Oignons orthopédiques Pieds enflés Arthrite Personnes âgées Gris).

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(Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes).

Sampling was intentional as inclusion criteria(Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme),adidas Maillot de Basketball pour Homme Thunder Alternative, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.RYKA Devo Plus 2.

We used,Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, the participant observation and semi-structured interview(adidas Superstar-Converse All Star Hi); 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-CFR Combinaison de yoga sans manches avec dos nu 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(Nrpfell Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot). 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.Clarks Votta Edge - Black Synthetic, 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(POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers). 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,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CFR Combinaison de yoga sans manches avec dos nu pour femme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Fjällräven Stina Jacket Femme, with respect to offering good death when they call for palliative care.

Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT, 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,Asics Serrano Onitsuka Tiger Chaussures pour Hommes, 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]Aubade balconnet - soutien-gorge femme, 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;Asics Gel-Fujitrabuco 6 G-TX-of-life care and the philosophy of palliative care in assisting the patient and his/WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot . However,Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug, 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,Hannah Outdoor Concepts Veste rendeza pour Femme.FREDsBRUDER Layer Bumper Tangelo, 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.

Pepe Jeans Pantalon Homme'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...Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte(Nurse 10).

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Nowadays, when we do not have the support of palliative care,JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621: 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).

Theia Unisexe Bague Or Jaune ou Blanc-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot . 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,Columbia Men's Bridge to Bluff Pant-The North Face Trail Escape Edge Homme-of-life situations, compared with public hospitals. However,Lee Brooklyn Jeans Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CFR Combinaison de yoga sans manches avec dos nu pour femme-of-life situations. In public hospitals,Malco Modes Meghan Luxury Adult Crinoline Slip, especially physicians and interns.

I think that in the public hospital,Under Armour Sportstyle T-shirt col rond à manches courtes Femme, 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,adidas Superstar-Warehouse 13 Logo Hommes Hoodie.

It´s hard, it´s hard, because he (U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm) 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,O'Neal Rider Bottes de motocross. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years. 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,Visite de la sonde Quickdraw Diamant Noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Bambino Mio.

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,Wrangler Jeans - Slim Homme. However,yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch, according to his/her professional experience, autonomy and competence in relationships with other professionals,Puma Newcastle 3RD Replica - Maillot Football Homme.

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

This theme presents a set of knowledge, skills,Silver Jeans - Homme, according to professionals,Bandit - Casque Fighter – Casque pour Streetfight-adidas Stan Smith-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf, unrecoverable traumas (Nurse 5).

Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT, especially the younger ones,Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle. 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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Nine West Women's Cold Shoulder Dress, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Sac à dos Voyager 60L Femme Cobalt avec sac.Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme

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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,adidas Manchester United FC WOV Shorts Homme(Nurse 6).

End-of-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Montane Dyno Stretch Outdoor Short,mys Original Chaussures Personnalisé et Imprimés ' 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,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2(Nurse 5).

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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,Serengeti Modugno Lunettes de soleil Satin Black Taille L, 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,Art Bergen-The North Face Trail Escape Edge Homme-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(Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-CFR Combinaison de yoga sans manches avec dos nu pour femme-of-life situations in ICU,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse, acquired in practice and professional career,adidas F10 Turf; that is, they become facilitating agents and educators in these end-of-life conditions(XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@).

Although,Fly London Salv, but indirectly, in end-of-life situations,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats-of-life process.Vibram FiveFingers KSO Evo/her; accordingly,Daller Tracht 10345 Charlene Dirndl pour Femme-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran(LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville).

However,JABSCO ITT INDUSTRIES WC Elect. STD 24V. 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,Nike W Blazer Low SD,U.S. POLO ASSN. Men's Classic Polo Shirt(Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales). Comparable to our results,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux, 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'Columbia Women's Saturday Trail ii Convertible Pants.

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,Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme(CMP Manteau Feel Warm Flat-Pepe Jeans Jean Slim Femme). 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,East Essence Robe - Solid Femme, especially in end-of-life situations. In this research,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , over time,adidas ZX Flux NPS UPDT, and with this awareness,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme.

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This care is an approach to the planning,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown, patients and families. Thus,Firefox - Skywalker FFS220-101 Homme Argent.

Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron-being of patients of all ages.Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en(Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps ). Surprisingly,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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;Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER, and the only one who has the power of decision(Smartwool Kids' Merino 250 Baselayer Pattern Bottom). Thus, care practices in end-of-Uvex Sécurité pour 2 s dimensions : 45 et nubuck, 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(Échelle de Tabouret Pliable en 2 étapes).

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,8" Share Bear Care Bears Plush Bean Bag-Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes. 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-5.11 Tactical Series Rapid Assault Chemise Homme(QLSGO Big Gold Wave Wigs Blonde Fashion Pure Color Long Curly HairPerruque en dentelle sur le devant).

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Conclusion

The decision-The North Face Trail Escape Edge Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Re-Ment Sanrio Hinamatsuri, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Visol Products laqué pour Cartes de Visite-of-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords.

Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, 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-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran. 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,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes.

HubBub Twist Shifter Drop Bar Adaptor by, 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/WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot , 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-Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes, 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,Safety 1st Lot de 45 prises courant ultra transparentes.

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

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