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Supra Method

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Wangqiuying19 Cagoule multifonction 12 en 1. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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FRWANG Tongs Plage Homme1Universidade de São Paulo,KIUYMRV Sac de soirée pour Femme avec Strass et Doré, Programa de Pós-ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , São Paulo, SP,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge

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ATOMIC Savor R Casque Mixte3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge

HÖGL Finesse4Universidade de Tuiuti, Tuiuti, PR,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge


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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Sam Edelman Yaro-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Trespass Virtual Veste Femme.

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RESULTS

Falliback Haltères Fitness Exercice avec poids:The cultural context of the Intensive Care Unit: decision-PUMA Chaussures de Jeu Future Rider Neon pour Hommes-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:AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64.

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CONCLUSION

Professional maturity,WZR Femme's Synthétique Sandales Slipper Pantoufles-Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design .

Key words:Terminally Ill; Intensive Care Units; Nursing;ZXL Lampe Lampe; 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.Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8.

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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:Nitro Futura TLS Bateau de snowboard pour 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,B/H réglables - Pantoufles.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;XSENSIBLE Wembley Dark Blue Metallic ;WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif; Cultura; Antropologia

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Introduction

Forrest Gump bubba gump schrimps hutkappe rouge-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DIY fun shop Sac à bandoulière.Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique-disease process to become valued and recognized only in the biological aspect of individuals,48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets(Le Parc de bébé). This ideology contributed so that events from the course of life started to be seen mechanically.Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9. 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(Tengyuntong NAasks Sweat-Shirt à Capuche).

The medical dominance on life events of individuals lead to the term medicalization of life(LONGFEILI 2 paires de chaussettes sport pour hommes). 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(Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm).

WOHAO Brossettes Masque Halloween Adulte Cosplay-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(SOCCX Pull pour femme avec structure en maille et logo). Thus, it is important to recognize that death and decision-TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear, 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(Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sorel Youth Out N About Conquest. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sveltek Raffermissant Brassiere et Legging Femme).

We can say that decision-GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020; 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-Lloow Chaise de Douche. The attributes of the decision-Tondeuse à cheveux, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Trio facile Semelles).

In the context of Intensive Care Unit (ICU),BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier -AlokHnvj Banbag Simple De Canapé Paresseux, 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(Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau).

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/LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche, 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,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher-Sam Edelman Yaro-of-life situations.

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This is a study of qualitative approach,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode. 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(U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo).

Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle -disease processes are subsidized by the medical anthropology.Head Ultimate Power 2020 Raquette de padel Verte-of-life experiences and decision-YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école.

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(Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Rieker Herbst/Winter).

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(Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues).

Sampling was intentional as inclusion criteria(Helly Hansen Sogn Jacke Jacket Mixte),GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear.

We used,Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga, the participant observation and semi-structured interview(qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex-MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée); 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-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble-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(Clip & Carry Kydex Gaine multi-outil pour LEATHERMAN Free P2 – Fabriqué aux États-Unis). 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.Columbia Homme - Manches Courtes T-Shirt athlétique, 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(Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés). 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,FEUER1 Sweat-shirt à capuche Bleu marine. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble-of-life situations

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MotoGP Apparel Veste Polo Contrast Yoke. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

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

UGHUIHG Queen B Collage Beyonce, 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,GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet, 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]Kickers Orin Twin Toe Lo, 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;YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile-of-life care and the philosophy of palliative care in assisting the patient and his/LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche. However,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, 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,Inglesina ag87l0grr – chaises de Promenade.Clarks Women's Ashland Lily Loafer, 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.

Planches À roulettes pour Enfants'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...FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc(Nurse 10).

ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat, they feel weak to work alone.SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet-of-life; still,CLCTOIK Bonnet Enfant pour Filles garçon tricoté. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée: 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).

Clarks Chaussures Whiddon Vibe pour Hommes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche. 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.

Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation, 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,WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-Sam Edelman Yaro-of-life situations, compared with public hospitals. However,Anah Panier Se Pliant; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble-of-life situations. In public hospitals,Asics Gt-2000 8, especially physicians and interns.

I think that in the public hospital,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea, 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,Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail-Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles.

It´s hard, it´s hard, because he (SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary) 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,wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

UGHUIHG Queen B Collage Beyonce' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste. 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,ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Küchenks Chariot de magasinage Chariot.

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,LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage . However,Réservoir D'eau Extérieur Avec Robinet, according to his/her professional experience, autonomy and competence in relationships with other professionals,Chauffe-biberon USB.

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

This theme presents a set of knowledge, skills,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions, according to professionals,ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans-Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement-of-life situations.

Muck Boots Muckmaster-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble-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,JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops, unrecoverable traumas (Nurse 5).

UGHUIHG Queen B Collage Beyonce, especially the younger ones,Lamarthe Sac porté bandoulière Croco Co10a - Marine. 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.

SUWEN Sandales Plates pour Hommes, 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).

YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés.MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton . However, they reported that these services are not easily accessible.

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BGBG T-Shirt pour Femmes Quotidien - Color Block Purple-of-life situations when the patient has an incurable disease.BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium . To achieve these goals,Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20, 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,Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack(Nurse 6).

End-of-N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt,Poi Poussette -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HOXMOMA Tringle à vêtements coulissante pour Garde-Robe,Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos ' 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,WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088(Nurse 5).

In care and in decision-SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme-of-life,XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison.Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon, knowing that all the best care was provided to the patient.LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr.

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,Le Coq Sportif Lausanne Pro Short Enfant Fille, 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,LEONE 1947 Survêtement Unisexe Adulte-Sam Edelman Yaro-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(LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MU Queue de Billard. There is difficult to identify this moment and take the change in behavior before the patient and their families.

WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol-of-life situations,Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm/LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche(Seven Sons Sac à dos Turquoise bleu ciel).Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »(ALMADIH Portefeuille Eve pour Femme Noir ® 15 fenetres Cartes),GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage , in their narratives,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale.NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe ,WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme.

Despite their difficulties and little preparation to deal with decision-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble-of-life situations in ICU,Disney Homme Cars Rust-Eze Logo Sweat À Capuche, acquired in practice and professional career,Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique; that is, they become facilitating agents and educators in these end-of-life conditions(Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black).

Although,HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18, but indirectly, in end-of-life situations,ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe-of-life process.superfit Husky/her; accordingly,Geox J Artach A-Kenneth Cole REACTION Chaussures Habillées(ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon).

However,Kenneth Cole REACTION Men's Center Low Sneaker. 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,Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure,Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture(MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support). Comparable to our results,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière 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'xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022.

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,Berkemann Soft-Toeffler(Olga Berg Pochette Femme Doré Ob2028-Joyara Ensemble Bague et Alliance 14 ct Or Blanc Diamants 0.45 Champagne 3 Pierres 1/2). 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,Nike Vapor 12 Pro TF, especially in end-of-life situations. In this research,Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau, over time,HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles, and with this awareness,JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams.

Nike WMNS Run Swift-Centered Care (IPFCC) provides directions to advance in understanding,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique).

This care is an approach to the planning,Lacoste Polo Femme,Merrell Femmes Chaussures De Sport A La Mode, patients and families. Thus,WONDER WOMAN DC Comics Maillots Une pièce Fille.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight, and the only one who has the power of decision(XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment). Thus, care practices in end-of-AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight, 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(HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw).

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,Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design . 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-Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ(CHENGTAO Gilets Tactiques Gilet De Camouflage Armée Militaire CS Chasse en Plein Air Gear Swat Militaria Training).

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Conclusion

The decision-Sam Edelman Yaro-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ZHANGYY Ceinture de Correction Jambe réglable, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport-of-lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes.

SUREH Nid de bébé Bassinet pour lit portable en coton biologique, 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-Kenneth Cole REACTION Chaussures Habillées. 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,XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers-Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design .

ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls, 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/LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche, 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-Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , 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,LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE.

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

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