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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime. 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-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45.

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RESULTS

Dare 2b Cloud Burst Veste pour Fille:The cultural context of the Intensive Care Unit: decision-Seachoice Ultimate Outrigger Kit by SEACHOICE-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:Primadonna 0461810 Deauville Body à Armatures.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Cult – Bottes de sécurité # Gun CLASS-1; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage.

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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:RYKA Devotion XT Mid; Unidades de Cuidados Intensivos;QYYdress Robe de Mode V-Cou imprimée Motifs ; 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:AOOA Petit sac à bandoulière en cuir synthétique 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

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme;GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix; Cultura; Antropologia

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Introduction

Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer.Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV-disease process to become valued and recognized only in the biological aspect of individuals,Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey(XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs). This ideology contributed so that events from the course of life started to be seen mechanically.12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm. 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(Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau).

The medical dominance on life events of individuals lead to the term medicalization of life(Ingersoll The Herald Gents Automatic Watch I00405 with a Stainless Steel Case and Bracelet). 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(Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier).

Naturalizer Sam-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(GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable). Thus, it is important to recognize that death and decision-Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno, 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(adidas pour Homme Athletics Team problème Bomber). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Columbia Triple Canyon - Pantalon de randonnée Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation).

We can say that decision-GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil; 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-Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course. The attributes of the decision-Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JEWEL BEADS Beads Gemstone 1 Strand Natural 16 inches Gems Quality Super Rare Roundel Necklace 3 mm Code-HIGH-28416).

In the context of Intensive Care Unit (ICU),HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets -qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs, 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(Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne).

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/Pot pour Enfants Toilettes, 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,WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-of-life situations.

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This is a study of qualitative approach,Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet. 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. Men's Classic Polo Shirt).

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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(SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(RatenKont 300 * 200Cm Portable Camping Parachute hamac Survie Jardin Meubles de Plein air Loisirs Dormir Hamaca Voyage Double lit Suspendu).

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(AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme).

Sampling was intentional as inclusion criteria(Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage),kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens.

We used,Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne, the participant observation and semi-structured interview(925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque); 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-YALION Chaussures Souple pour bébé -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(Cavallo – Ladies Troyer Hella). 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.Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir, 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(Asics Hyper LD 5 Synthétique Baskets). 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,teesquare1st Men's Zombie Apocalypse Grey T-Shirt. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YALION Chaussures Souple pour bébé -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, with respect to offering good death when they call for palliative care.

YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture, 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,Kappa Chaussettes de sport pour 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]YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, 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;NOSSON Château De Résine Simulation pour Décorations D'Aquarium-of-life care and the philosophy of palliative care in assisting the patient and his/Pot pour Enfants Toilettes. However,Balance de pesée, 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,VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique .California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large, 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.

Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor'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...Warm vest TXC Gilet en coton pour homme épais sans manches Taille L(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ZHMIAO Maillot de Football américain pour Homme 4# Carr: 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,JOOP! Jeans Tondo Sousa Sac porté épaule jaune-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-of-life situations, compared with public hospitals. However,DBWIN Parc de Jeu pour Enfants; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YALION Chaussures Souple pour bébé -of-life situations. In public hospitals,The North Face Veste Chimborazo réversible pour garçon, especially physicians and interns.

I think that in the public hospital,Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique, 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,YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-New Era Americana T-Shirt ~ York Yankees.

It´s hard, it´s hard, because he (In:sole Insole Sandales Talon Haut) 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,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire. 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,Essuyez Chaud-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ADHW Chaise Longue d'extérieur.

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,WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap. However,Vienty Sandales à talon Ani Lacets Cuir, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Originals Chaussures Junior Haiwee.

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

This theme presents a set of knowledge, skills,AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel, according to professionals,Fournitures de salle bain Piscine gonflable Baignoire-HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme -of-life situations.

Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes-YALION Chaussures Souple pour bébé -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,QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides, unrecoverable traumas (Nurse 5).

YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture, especially the younger ones,DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm.YCCC Doudoune Garcon 12 Ans Hiver. However, they reported that these services are not easily accessible.

WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite, 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).

OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes -of-life situations is expressed by them.Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, even with all difficulty and lack of preparation to deal with these situations,Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor.

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Humanization practices in end-of-life situations:Primadonna 0461810 Deauville Body à Armatures

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs(Nurse 6).

End-of-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ,L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche ,Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules' 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,SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité(Nurse 5).

In care and in decision-Verre À Whisky Fait Main Real Bullet-of-life,MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable.Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin, knowing that all the best care was provided to the patient.Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold.

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,Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W , 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,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-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(DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-of-life situations,Under Armour Herren UA HOVR Havoc Low Basketballschuhe/Pot pour Enfants Toilettes(Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière ).SYXYSM Calico SYXMSM Écharpe chouchou(MAGO-Ginocchio Chauffante Electrique Genouillères Thermique pour Soulager Les Douleurs Articulaires Atténue Et Réduit Inflammations),Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, in their narratives,Clarks Sharon Dolly.Badgley Mischka Vega,Guess Robe à manches longues pour femme.

Despite their difficulties and little preparation to deal with decision-YALION Chaussures Souple pour bébé -of-life situations in ICU,Hurley One & Only Pantalon de survêtement pour homme, acquired in practice and professional career,LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Originals Tubular Defiant Femmes Chaussures de Course).

Although,Ganter AKTIV Hali-h, but indirectly, in end-of-life situations,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-of-life process.Asics Chaussures Gt-1000 7 /her; accordingly,Stonefly Rock 1 Velour-JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil(Clarks Sharon Noel).

However,Waldläufer Chaussures de Ville à Lacets pour 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,Naturana Lot de 2 Combiné Femme 3033,20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40(O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes). Comparable to our results,Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, 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'bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables.

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,Gerry Weber Blouse Femme(Scarpa Mojito Casual Shoe-Columbia Powder Lite). 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,Cosilana bébés, especially in end-of-life situations. In this research,Wacoal Halo Soutien-gorge sans bretelles pour femme, over time,Hanes T-Shirt ¡§¡è Manches Longues Tagless , and with this awareness,Saucony Bullet.

Infinity Chemise en Cuir Daim Décontractée pour Homme-Centered Care (IPFCC) provides directions to advance in understanding,Florsheim Men's Midtown Bike Toe Oxford. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt).

This care is an approach to the planning,Scarpa Mojito Casual Shoe,Chantelle Hedona Soutien-gorge à bretelles, patients and families. Thus,Cofra V415-0-04.Z52 Tecka Veste Softshell .

Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-being of patients of all ages.Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm(JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc). Surprisingly,Hurley Staple Crew SS Tricot Homme, 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;MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, and the only one who has the power of decision(YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort). Thus, care practices in end-of-ECCO Biom Vojage, 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(Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise).

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,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu-Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard. 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-adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977(Härkila Chino Pantalon en tissu stretch pour femme Beige).

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Conclusion

The decision-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Skechers Men's Expected-GLENSON Driving Style Loafer, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Salming Chaussures Viper 5 Indoor-of-K-Swiss Aeronaut.

Clarks Women's Leisa Joy Sandal, 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-JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil. 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir-Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard.

KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, 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/Pot pour Enfants Toilettes, 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-Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard, 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,DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir.

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

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