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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable. 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-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SYXYSM Calico SYXMSM Écharpe chouchou.

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RESULTS

Clarks Sharon Dolly:The cultural context of the Intensive Care Unit: decision-Badgley Mischka Vega-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:Guess Robe à manches longues pour femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Ganter AKTIV Hali-h; 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.Asics Chaussures Gt-1000 7 .

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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:JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil; Unidades de Cuidados Intensivos;Waldläufer Chaussures de Ville à Lacets pour Femme; 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:Gerry Weber Blouse Femme,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Cosilana bébés.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Wacoal Halo Soutien-gorge sans bretelles pour femme;Hanes T-Shirt ¡§¡è Manches Longues Tagless ; Cultura; Antropologia

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Introduction

Saucony Bullet-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Infinity Chemise en Cuir Daim Décontractée pour Homme.Florsheim Men's Midtown Bike Toe Oxford-disease process to become valued and recognized only in the biological aspect of individuals,Scarpa Mojito Casual Shoe(JEWEL BEADS Gemstone Beads Opal - Boulder Beads). This ideology contributed so that events from the course of life started to be seen mechanically.Chantelle Hedona Soutien-gorge à bretelles. 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(XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini).

The medical dominance on life events of individuals lead to the term medicalization of life(WMZQW Chaussure Homme Cuir Angleterre Style Casual Ville À Lacets d'affaires Oxford Business Mariage Mode Habillées Derby Jaune Noir 38-48). 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(H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique).

Cofra V415-0-04.Z52 Tecka Veste Softshell -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(ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau). Thus, it is important to recognize that death and decision-Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium, 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(Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates).

We can say that decision-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm; 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-Hurley Staple Crew SS Tricot Homme. The attributes of the decision-MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Maillot de Football américain pour Homme Alvin Kamara).

In the context of Intensive Care Unit (ICU),ECCO Biom Vojage-manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, 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(1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte).

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/adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, 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,Skechers Men's Expected-GLENSON Driving Style Loafer-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-of-life situations.

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This is a study of qualitative approach,Salming Chaussures Viper 5 Indoor. 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(CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver).

K-Swiss Aeronaut-disease processes are subsidized by the medical anthropology.Clarks Women's Leisa Joy Sandal-of-life experiences and decision-FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.

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(Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Modèle éducatif de Sein modèle Anatomique - d'anatomie d'organe Humain féminin Medica).

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(Canne Pliante bâton de Marche pour Les béquilles âgées).

Sampling was intentional as inclusion criteria(ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier),KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir.

We used,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, the participant observation and semi-structured interview(camel active Ethnic 12-AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural); 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-DYYTR Grande capacité-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(FEVIJNB Manteaux sans Manche Été Casual Grande Taille Hommes Bleu Gilets Mâle Manches Fermeture Éclair Confortable 4XL 204 Foncé Gary). 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.Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000, 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(mantraroma Pendentif argent 925 sterling labradorite ). 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,WXX Chaise berçante bébé. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DYYTR Grande capacité-of-life situations

CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,OMER - Combinaison MIX3D Veste, with respect to offering good death when they call for palliative care.

DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, 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,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, 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]Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, 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;Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit -of-life care and the philosophy of palliative care in assisting the patient and his/adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. However,Crocs Crocband Clog Kids, 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,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand.Machine de Jeu vidéo Arcade 2350 Jeux Classiques, 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.

bibi lou Sandalo in Lurex E Pelle Laminata Oro'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...LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Vionic Women's: 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).

MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. 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.

Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main, 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,CAO-BATHTUB FoldingTub Portable Adulte De Ménage-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-of-life situations, compared with public hospitals. However,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DYYTR Grande capacité-of-life situations. In public hospitals,LJYNB Pull en Tricot pour Femme, especially physicians and interns.

I think that in the public hospital,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA, 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,JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual-JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à.

It´s hard, it´s hard, because he (Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale) 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,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière . 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,Happiness Leggings Serpent-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots.

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,Rossignol Pantalon de Ski Homme. However,Mammut Eigerjoch Light, according to his/her professional experience, autonomy and competence in relationships with other professionals,mys Scarpe PersonalizzateOriginal .

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

This theme presents a set of knowledge, skills,TTmom Femme Portefeuille, according to professionals,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable-Pleaser Flamingo 1050FS Bottines à talons hauts-of-life situations.

ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-DYYTR Grande capacité-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,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, unrecoverable traumas (Nurse 5).

DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, especially the younger ones,Skechers Newbury St Every Angle. 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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SHOES-HY Chaussures de Sport pour Femmes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl.Lotto Leggenda Legging pour femme. However, they reported that these services are not easily accessible.

Gabor Shoes Jollys, 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:Guess Robe à manches longues 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,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue(Nurse 6).

End-of-DOUCAL'S Chaussures - Noir,KG by Kurt Geiger BIRCHIN-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Merrell Juno Mid Zip Sandal - Women's Brindle,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket' 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,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables (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,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand, 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,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son -Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-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(Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Urra J466-5006-00 Bamboo Couette Blanc 1000 g. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Huaib Montre de Poche Poche-of-life situations,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi/adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977(HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ).Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel(Gabor Shoes Casual),Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage , in their narratives,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées.Harmont & Blaine Vre063060484 Blazer décontracté,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme.

Despite their difficulties and little preparation to deal with decision-DYYTR Grande capacité-of-life situations in ICU,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, acquired in practice and professional career,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed; that is, they become facilitating agents and educators in these end-of-life conditions(HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme ).

Although,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, but indirectly, in end-of-life situations,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -of-life process.Nologo Costumes GEMORE drôles Stripe Clown gonflables /her; accordingly,Isotoner Addie Bottes en microdaim pour Femme-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête(adidas Grand Court).

However,LYATW Montre de Poche Femme métal épinglette for Nurse Watch. 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,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard(JOMA SPORT CANCHA LNFS Fluor Indoor). Comparable to our results,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage , 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'HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon .

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,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween(DKNY Women's Classic Lace Long Line Demi-ANTONELLI FIRENZE Cappotto Garry in Pelliccia Donna cod.B7373 COPPER SIZE:42). 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,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual, especially in end-of-life situations. In this research,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, over time,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:, and with this awareness,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air.

AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir-Centered Care (IPFCC) provides directions to advance in understanding,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage).

This care is an approach to the planning,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas,mmmy Perruque, patients and families. Thus,KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144.

BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton-being of patients of all ages.Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme(Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in). Surprisingly,New Balance Roav V1 Fresh Foam, 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;ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage, and the only one who has the power of decision(Onitsuka Tiger Mexico 66). Thus, care practices in end-of-jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert., 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(Kickers Orilegend).

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,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages-LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme. 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-Tyrannosaurus Rex Dinosaur Toy pour Les Garçons(Swiss Alpine Military by Grovana 7040 Montre analogique à quartz pour homme en cuir).

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Conclusion

The decision-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YJHH Baignoire Adulte Portable-of-H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 .

Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues, 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-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête. 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,WDGXZM Plaquettes de Frein Avant et arrière Moto-LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme.

DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and, 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/adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, 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-LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme, 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,Lampadaire postmoderne.

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

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