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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Planches À roulettes pour Enfants. 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-Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Anah Panier Se Pliant.

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RESULTS

Asics Gt-2000 8:The cultural context of the Intensive Care Unit: decision-LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-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:Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail.

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CONCLUSION

Professional maturity,Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles-SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary.

Key words:Terminally Ill; Intensive Care Units; Nursing;wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros; 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.ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot.

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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.

Palabras-clave:LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage ; Unidades de Cuidados Intensivos;Réservoir D'eau Extérieur Avec Robinet; Toma de Decisiones; Cultura; Antropología

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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:Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops;Lamarthe Sac porté bandoulière Croco Co10a - Marine; Cultura; Antropologia

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Introduction

SUWEN Sandales Plates pour Hommes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard.Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés-disease process to become valued and recognized only in the biological aspect of individuals,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton (GBY Maillot de Basket-Ball Heat n ° 3 Wade). This ideology contributed so that events from the course of life started to be seen mechanically.Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant. 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(JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces).

The medical dominance on life events of individuals lead to the term medicalization of life(Columbia Powder Lite). 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(Asics Gel-Fujitrabuco 6 G-TX).

QFYD FDEYL Montants Diabétiques Réglable Orthopédique -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(KGAYUC Mot Épaule Robe De Soirée Verte). Thus, it is important to recognize that death and decision-GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage , 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(Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZSMD Phicen Vêtements Femme échelle 1/6 Main. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui).

We can say that decision-BGBG T-Shirt pour Femmes Quotidien - Color Block Purple; 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-BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium . The attributes of the decision-Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Härkila Chino Pantalon en tissu stretch pour femme Beige).

In the context of Intensive Care Unit (ICU),Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack-N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt, 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(Geox D Thymar F).

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/Poi Poussette , 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,HOXMOMA Tringle à vêtements coulissante pour Garde-Robe-Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation-of-life situations.

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This is a study of qualitative approach,Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos . 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(Daller Tracht 10345 Charlene Dirndl pour Femme).

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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(Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WZLJW Jouets en Peluche - 24cm Thumper Lapin Enfants Animaux for Les Cadeaux ggsm).

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(Clarks Women's Ashland Lily Loafer).

Sampling was intentional as inclusion criteria(Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's),Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon.

We used,LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr, the participant observation and semi-structured interview(WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon -Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.); 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-Le Coq Sportif Lausanne Pro Short Enfant Fille-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(Keliour Chronomètre Horloge Murale Mural avec chronomètre minuterie à numérique Del for l'entraînement Distance). 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.LEONE 1947 Survêtement Unisexe Adulte, 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(Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm). 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,MU Queue de Billard. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Le Coq Sportif Lausanne Pro Short Enfant Fille-of-life situations

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Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich ». 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,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale, with respect to offering good death when they call for palliative care.

NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe , 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,WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme, 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]Disney Homme Cars Rust-Eze Logo Sweat À Capuche, 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;Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique-of-life care and the philosophy of palliative care in assisting the patient and his/Poi Poussette . However,HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18, 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,ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe.superfit Husky, 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.

Geox J Artach A'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...Kenneth Cole REACTION Chaussures Habillées(Nurse 10).

Kenneth Cole REACTION Men's Center Low Sneaker, they feel weak to work alone.Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure-of-life; still,Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022: 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).

Berkemann Soft-Toeffler-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Poi Poussette . 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.

Nike Vapor 12 Pro TF, 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,Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau-Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation-of-life situations, compared with public hospitals. However,HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Le Coq Sportif Lausanne Pro Short Enfant Fille-of-life situations. In public hospitals,JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams, especially physicians and interns.

I think that in the public hospital,Nike WMNS Run Swift, 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,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-Lacoste Polo Femme.

It´s hard, it´s hard, because he (Merrell Femmes Chaussures De Sport A La Mode) 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,WONDER WOMAN DC Comics Maillots Une pièce Fille. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt. 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,CafePress BRIGHTGREYSAATOMY PJ pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HÖGL Studio 80.

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,Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge. However,AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight, according to his/her professional experience, autonomy and competence in relationships with other professionals,AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight.

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

This theme presents a set of knowledge, skills,Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes, according to professionals,Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ-ZHANGYY Ceinture de Correction Jambe réglable-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,lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes, unrecoverable traumas (Nurse 5).

NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe , especially the younger ones,SUREH Nid de bébé Bassinet pour lit portable en coton biologique. 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.

XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers, 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).

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Yhjkvl Hommes Gym Legging Fitness, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail

Cxjff Pliant PedaI Tricycle-of-life situations when the patient has an incurable disease.DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme. To achieve these goals,Baignoire Pliante pour bébé, 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,Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long(Nurse 6).

End-of-RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser ,AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine,Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack' 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,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges(Nurse 5).

In care and in decision-Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy -of-life,FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle.ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau, knowing that all the best care was provided to the patient.WYNZYSLBD Gilet De Sécurité Haute Visibilité.

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,MYMAO Pluie épaisse Ponchos ~ Qualité Premium, 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,DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette-Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation-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(Nike M nK sQD coutil Top Shirt à manches longues). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hudson baby Long Sleeve Bodysuits. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14-of-life situations,Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose/Poi Poussette (Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings).Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc(EAC 41240 046 eagle creek Pack-it Specter On Board G Beauty Case),nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie, in their narratives,SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt.LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux,Reborn Baby Dolls.

Despite their difficulties and little preparation to deal with decision-Le Coq Sportif Lausanne Pro Short Enfant Fille-of-life situations in ICU,HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël, acquired in practice and professional career,Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu ; that is, they become facilitating agents and educators in these end-of-life conditions(P D PAOLA Bracelet Paola PU02-036-U femme argent).

Although,weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm, but indirectly, in end-of-life situations,Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr-of-life process.Clavie Boucles d'Oreilles Pendantes Or Jaune 750 Émeraude VVS1 0.73ct Vert Goutte Cadeau Femme/her; accordingly,HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces-SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet(JALAL Couronne de blé Noël).

However,TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W. 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,YzDnF Regarder dislpay Box Organisateur Durable 10 Grids Montre Affichage Boîte De Rangement Bijoux Étui en Cuir Portable Zippered Afficher for Hommes Femmes,Deer Original Cerf-Volant(Geox Jr Agata A). Comparable to our results,nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie, 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'FACAZ Light The Wine Diamond Decanter Set Holding Base.

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,Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih(Kanna Shoes Sandalia CUÑA Basket Kaki-Yowablo Chaussures Sandales Homme Summer Beach Respirant Home Slipper Tongs Plates). 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,EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques, especially in end-of-life situations. In this research,KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne, over time,qazxsw Miroirs de Maquillage vanité Mur lumière 8 Pouces LED Simple Face avec Interrupteur 3X grossissant Salle Bain Rasage Bras réglable Miroir cosmétique, and with this awareness,XXLYY Appliques murales réglables minimalistes modernes Éclairage Lampe de travail à bras pivotant long Étude Salon Lecture Applique murale Métal E27 Lanterne chevet chambre coucher .

JOMA SPORT CANCHA LNFS Fluor Indoor-Centered Care (IPFCC) provides directions to advance in understanding,ZJIIXON Sweat-Shirt imprimé en 3D. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit).

This care is an approach to the planning,FUKAI Nouveau Simple Luxueux Potentiel Perle Bell Bracelets en Argent Bracelet De Mode Marée Tendance Perles Jingle Bijoux Cadeaux,Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925, patients and families. Thus,U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme, and the only one who has the power of decision(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur). Thus, care practices in end-of-My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore, 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(AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski).

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,Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light -SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary. 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-THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir(Tommy Hilfiger TJM Tape Sweater Shirt Homme).

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Conclusion

The decision-Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey-of-AWJ Barre d'appui de Douche.

FACAIA Couronnes de Noël, 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-SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. 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,KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes-SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary.

CYYMY Hula Hoop, 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/Poi Poussette , 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-SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary, 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,Philipp Plein Jean Super Straight Stretch.

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

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