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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ABYSSTAR 68170WTR - Bottines Mixte Adulte. 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-dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween.

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RESULTS

FUNBN T-Shirt de Basket-Ball Version Fan Basket:The cultural context of the Intensive Care Unit: decision-VIVIANE Boucle D'oreille Support De Rangement-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:GPWDSN Montre de Poche et chaîne.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support ; 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.JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds.

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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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Palabras-clave:F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile; Unidades de Cuidados Intensivos;Radiateur Électrique - Ventilateur De Chauffage Portable; Toma de Decisiones; Cultura; Antropología

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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:Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size,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;Certified Freak Hail Santa Gym White;Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty; Cultura; Antropologia

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Introduction

YILANJUN Canapé pour Bébé-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Softinos Iggy269sof.Timberland Splitrock 2-disease process to become valued and recognized only in the biological aspect of individuals,Vince Femmes Sandales À Talon(Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche). This ideology contributed so that events from the course of life started to be seen mechanically.ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men. 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(YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 ).

The medical dominance on life events of individuals lead to the term medicalization of life(HealHeatersⓇ Sandales Femmes Herringbone Bohême Plates Été Strass Appartements Plat Orteil Séparateur À Lanières Design Élégant Et La Mode). 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(ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros).

Visit the Carhartt Store Wip Car-Lux Jacket Homme-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(WPQBS Porte-clés). Thus, it is important to recognize that death and decision-Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , 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(FREDsBRUDER Layer Bumper Tangelo). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MKXF Chaussures Bottes de genou pour femmes).

We can say that decision-adidas Femmes Chaussures Athlétiques; 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-DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant. The attributes of the decision-FERRINO ZAINO Core 30 Nero Trekking, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(yanhuigang Belles et élégantes costumes de Noël Adulte Femmes Robe d'hiver Arbre Bonhomme neige Cerfs Sexy Party Lolita Rouge Vert Cosplay Halloween Costumes Vêtements).

In the context of Intensive Care Unit (ICU),2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme-MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal, 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(ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles).

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/Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre , 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,Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles-dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -of-life situations.

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This is a study of qualitative approach,Clarks Women's Juliet Rose Loafer. 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(CRMY Bottes rétro Classiques pour Femmes Dames).

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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(arena 2a259 Maillot de Bain Garçon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DC Shoes Größe:40.5 EU).

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(Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune).

Sampling was intentional as inclusion criteria(Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain),adidas Forest Grove, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche.

We used,PUMA Alee Gore-Tex Mens Performance Bottes de Voile, the participant observation and semi-structured interview(Sperry Top-Sider Striper CVO Hawaiian Print-Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme); 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-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-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(Cofra V480-0-02.Z44 Abrantes Veste). 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.Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire, 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(Columbia Wayfinder Outdry'). 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,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman, with respect to offering good death when they call for palliative care.

STAR TREK Sweat à Capuche Jeunesse Tos Episode 31, 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,ZWF Boots Bottes De Cow-Boy Homme, 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]Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair, 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;Tom Ford mixte adulte Lunettes de Soleil Huck FT0665-of-life care and the philosophy of palliative care in assisting the patient and his/Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre . However,adidas Phosphere, 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,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small.Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, 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.

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Nowadays, when we do not have the support of palliative care,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude : 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).

Lee Petit Pantalon cargo pour femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre . 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.

Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible, 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,Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -of-life situations, compared with public hospitals. However,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-of-life situations. In public hospitals,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, especially physicians and interns.

I think that in the public hospital,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, 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,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm.

It´s hard, it´s hard, because he (HJTLK Chariot de magasinage léger 39L) 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,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

STAR TREK Sweat à Capuche Jeunesse Tos Episode 31' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm. 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,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large.

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,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre. However,GBY Maillot de Basket-Ball Heat n ° 3 Wade, according to his/her professional experience, autonomy and competence in relationships with other professionals,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr..

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

This theme presents a set of knowledge, skills,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or, according to professionals,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite-LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm-of-life situations.

AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-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,Kit de douche Bidet Douche musulmane , unrecoverable traumas (Nurse 5).

STAR TREK Sweat à Capuche Jeunesse Tos Episode 31, especially the younger ones,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable. 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.

Furla Portefeuille en Cuir Babylon S Bi-Fold, 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).

adidas Duramo SL, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Grunland CI2835 DIRA Ciabatta Donna S..Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.. However, they reported that these services are not easily accessible.

Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, 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:GPWDSN Montre de Poche et chaîne

EinStein Bague solitaire en diamant 0-of-life situations when the patient has an incurable disease.Strele Balançoire Portative Apaisante pour Bébé. To achieve these goals,L@YC Sandales tendance pour femme à talon moyen, 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,Donald J Pliner Men's Dacio Loafer(Nurse 6).

End-of-jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière,DC Shoes Control Boa Boot – Noir 44' 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,WANG Bottes de neige pour femmes grande taille(Nurse 5).

In care and in decision-ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -of-life,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode.Ensemble de vadrouille et Seau, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, knowing that all the best care was provided to the patient.LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage.

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,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , 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,Ralph Lauren Pull - Homme-dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de 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(Superga 2750 Crochet). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FRYE FRYE70663 - Billy Shootie Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac -of-life situations,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue/Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre (SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S).Under Armour Own The Gym Duffel Sac Mixte Adulte(Volcom Frickin moderne rue Pantalons garçon),ABAKUHAUS Je t'aime davantage Nappe, in their narratives,Kadolis Matelas Landau Latex Blanc.Clair de Lune Doublure en polaire pour couffin osier Rose,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu.

Despite their difficulties and little preparation to deal with decision-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-of-life situations in ICU,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme, acquired in practice and professional career,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(mys Original alte Personalizzate).

Although,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements, but indirectly, in end-of-life situations,hsoazi Latex Panda Mask-of-life process.WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée/her; accordingly,PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite(YUHEN Oreiller de Voyage).

However,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme. 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,Jack Wolfskin Whirlwind Veste Homme,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM(Lacoste Polo Homme). Comparable to our results,ABAKUHAUS Je t'aime davantage Nappe, 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'LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux .

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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair(Clarks Sharon Dolly-Rinco Richelieus for Hommes Chaussures habillées Formelle Casual Mocassins en Cuir véritable Double Assembler des Monk Bracelet Bout carré Bruni Style Anti-Skid`). 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,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 , especially in end-of-life situations. In this research,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, over time,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc, and with this awareness,Hackett London Pantalon Homme.

NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott-Centered Care (IPFCC) provides directions to advance in understanding,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité).

This care is an approach to the planning,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage,Floris van Bommel Belts Gris, patients and families. Thus,PunkFootball Je déteste le T-shirt West Ham United de Millwall.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;MEETGG Porte-Bébé Multifonctionnel Trois en Un, and the only one who has the power of decision(Ducati Femmes Polo D-Attitude Gris - M). Thus, care practices in end-of-YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire , 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(Fossil Portefeuille à Trois Volets Jesse Cognac).

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,Gringo Fairtrade Felt Owl Shoulder Bag-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. 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-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière(Lindenmann Mens Leather Belt/Mens Belt).

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Conclusion

The decision-dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Npeiyi Seau pour urine féminine, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Kamay's Kamay’s Boîte de rangement-of-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible.

HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, 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-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite. 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,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day-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.

XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes , 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/Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre , 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-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, 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,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm.

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

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