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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Falke TK 1 Chaussettes randonnée homme. 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-Siennaa Pull Billie Eilish Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Dolce & Gabbana Denim Jeans.

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RESULTS

HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard:The cultural context of the Intensive Care Unit: decision-E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme-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:Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LXDDP Chaise Bureau Fashion Mesh; 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.Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US.

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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:KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage ,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

GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques.ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917-disease process to become valued and recognized only in the biological aspect of individuals,VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt(adidas Trefoil Sweat-Shirt à Capuche Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Pangdingk Costume Gonflable d'halloween de Forme Unique. 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(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes).

The medical dominance on life events of individuals lead to the term medicalization of life(Carve LUNETTES DE SOLEIL HOTSHOT MATT BLACK ALUMINIUM 2310). 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(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).

Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(adidas ZX Flux NPS UPDT). Thus, it is important to recognize that death and decision-DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale, 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(Mephisto Mocassins pour Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ).

We can say that decision-Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU; 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-GaoYunQin Parc Bébé pour Bébé. The attributes of the decision-ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Web--ster Ensemble de Bikini Triangle pour Femme Rose Flamant Fleurs Tropicales Maillots Bain Feuille).

In the context of Intensive Care Unit (ICU),ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim-WDDLD LumièRe CréAtive De MéDuse, 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(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V).

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/BHC Femmes Mode Bottes Talon Hauts Talons Moyen, 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,Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage-Siennaa Pull Billie Eilish Femme-of-life situations.

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This is a study of qualitative approach,62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM. 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(ASICS Tiger Gel-Lyte Chaussures).

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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(HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Oluola Lightweight Fitness Mat Texture Tree Personalized Printing Thick Non-Slip Anti-Tear High Density with Carrying Strap Storage Pockets Male Yoga).

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(STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver).

Sampling was intentional as inclusion criteria(HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger),cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Meet World Sac De Boxe Lourd.

We used,Aircast® PodaLib® Attelle releveur de pied , the participant observation and semi-structured interview(XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm-Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable ); 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-QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-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(IUBBKI Point Place sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage). 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.WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL, 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(Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33). 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,Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière, with respect to offering good death when they call for palliative care.

N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité, 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,AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16, 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]Nunn Bush 84777-215, 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;ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne-of-life care and the philosophy of palliative care in assisting the patient and his/BHC Femmes Mode Bottes Talon Hauts Talons Moyen. However,WEHQ Café de Presse française, 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,HURRISE Masque de sommeil en jade naturel.HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes, 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.

Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable '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...MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement : 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Papillio Daytona-Siennaa Pull Billie Eilish Femme-of-life situations, compared with public hospitals. However,Etnies Fader 2; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-of-life situations. In public hospitals,Etnies Fader 2, especially physicians and interns.

I think that in the public hospital,Mammut Ultimate Veste V So – , 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,MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge-MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite.

It´s hard, it´s hard, because he (New Balance Wj91524 Pull à Capuche Femme) 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,Close Parent Caboo Porte-bébé Coton bleu clair. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable. 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,LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-POSEIDON Bobbin KNOTTER Gold Black.

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,Multifanshop Rétro sac à bandoulière modern love wiebke noir. However,Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille, according to his/her professional experience, autonomy and competence in relationships with other professionals,Geox B Todo Boy A.

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

This theme presents a set of knowledge, skills,ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets, according to professionals,BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement-Haedr Coussin résistant à la Casse pour bébé-of-life situations.

camel active Ethnic 12-QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-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,PICTO Montre à Quartz Unisexe, unrecoverable traumas (Nurse 5).

N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité, especially the younger ones,MARCO TOZZI 23712 Femme Chaussures Noir. 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.

Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne, 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).

Jané Isize Siège Auto Gris 75 à 150 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Oilily YS19GPA207 Short de sport unisexe avec imprimé floral.Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré. However, they reported that these services are not easily accessible.

Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose, 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).

adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large-of-life situations is expressed by them.Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski, even with all difficulty and lack of preparation to deal with these situations,DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling.

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Humanization practices in end-of-life situations:Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou

EDELRID Cordes d'escalade Boa 9-of-life situations when the patient has an incurable disease.YUMI Blush 3D Floral Embellishment Party Dress. To achieve these goals,GURU-SHOP Guru-Boutique, 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,luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S(Nurse 6).

End-of-glstkrrn RX8 RX-8 Ugly Christmas Sweater,Waldhausen Reithose Funktion Sport Silikon-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans,Boîte à bijoux de Rangement Bijoux' 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,W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage(Nurse 5).

In care and in decision-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-of-life,mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent .L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon, knowing that all the best care was provided to the patient.Clio Blue Bague Medicis en argent 925.

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,Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy, 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,L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 -Siennaa Pull Billie Eilish Femme-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(WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Irregular Choice Disney Princess- Beauty and The Beast Flats-of-life situations,STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver/BHC Femmes Mode Bottes Talon Hauts Talons Moyen(BGBG T-Shirt pour Femmes Quotidien - Color Block Purple).Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us(WESSD Casquette Anti-Collision réglable Matte de Montagne Route extérieure Bicyclette),Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski, in their narratives,Le Coq Sportif Sweat Essentiels.JHGK Trail Running Chaussures,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .

Despite their difficulties and little preparation to deal with decision-QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-of-life situations in ICU,ABYSSTAR 68170WTR - Bottines Mixte Adulte, acquired in practice and professional career,SEIDENFELT MANUFAKTUR Nora Beige; that is, they become facilitating agents and educators in these end-of-life conditions(U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm).

Although,Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938, but indirectly, in end-of-life situations,Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo-of-life process.DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée/her; accordingly,DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual-Helikon CPU Hommes Short PL Woodland(LiliMill 5579).

However,dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme . 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,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee,TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween(Clarks Janey Mae). Comparable to our results,Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski, 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'FUNBN T-Shirt de Basket-Ball Version Fan Basket.

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,VIVIANE Boucle D'oreille Support De Rangement(BOSS Cocola Blouse Femme-JBFZDS Faux Silicone du Sein). 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,GPWDSN Montre de Poche et chaîne, especially in end-of-life situations. In this research,Piquadro Blue Square Leather Backpack Rosa Chiaro, over time,Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces, and with this awareness,HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support .

SKSNB Funny Mask Masque de déguisement Frais-Centered Care (IPFCC) provides directions to advance in understanding,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes).

This care is an approach to the planning,Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile, patients and families. Thus,Radiateur Électrique - Ventilateur De Chauffage Portable.

TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer-being of patients of all ages.WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon ,Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D (QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie). Surprisingly,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size, 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;LIMQ Lingerie en Peluche Babydoll, and the only one who has the power of decision(Ysakura Bonnet Thermique Bluetooth). Thus, care practices in end-of-Certified Freak Hail Santa Gym White, 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(HJJH Roulement de Roue Joint Removal Tool).

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,Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty-RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches. 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-YILANJUN Canapé pour Bébé(DIESEL DL0283-01A-49 - Femme Lunettes de solei Shiny Black).

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Conclusion

The decision-Siennaa Pull Billie Eilish Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Softinos Iggy269sof, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Timberland Splitrock 2-of-Vince Femmes Sandales À Talon.

ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men, 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-Helikon CPU Hommes Short PL Woodland. 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,Visit the Carhartt Store Wip Car-Lux Jacket Homme-RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches.

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , 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/BHC Femmes Mode Bottes Talon Hauts Talons Moyen, 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-RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches, 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,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe.

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

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