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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ARA Lissabon. 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-ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir.

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RESULTS

Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme:The cultural context of the Intensive Care Unit: decision-BYZ Tenda da bagno per USO Domestico-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:25L Daysack - Sac à dos résistant l'eau.

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CONCLUSION

Professional maturity,Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections-Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet.

Key words:Terminally Ill; Intensive Care Units; Nursing;Earth Origins Lyndon Leah Women's Black 9 Medium; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine.

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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:58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM; Unidades de Cuidados Intensivos;ARMADA Baxter Insulated Snow Jacket; 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:Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver,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,WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues .

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre ;LSX - Fauteuil Roulant Roulant; Cultura; Antropologia

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Introduction

Merrell Jungle MOC-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm.The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble-disease process to become valued and recognized only in the biological aspect of individuals,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube(WILSON Youth Classic Relaxed Fit Baseball Pant). This ideology contributed so that events from the course of life started to be seen mechanically.Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6. 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(YJHH Baignoire Adulte Portable).

The medical dominance on life events of individuals lead to the term medicalization of life(Archer Watch Straps | Bracelets de Remplacement en Nylon Facilement Interchangeables pour Montre Homme et Femme). 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(Verre À Whisky Fait Main Real Bullet).

DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG-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(Wacoal Bra Underwire Soutien-Gorge de Sport Femme). Thus, it is important to recognize that death and decision-SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, 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(Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim).

We can say that decision-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox; 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-REFRESH Bottine Plate avec Fermeture Éclair pour Femme. The attributes of the decision-HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d', which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Helly-Hansen Jotun Hooded Veste Homme).

In the context of Intensive Care Unit (ICU),Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière-YZT QUEEN Bottes Cuissardes Femmes, 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(Rideau de fenêtre hawaïen avec des arbres montagne).

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/Andrea Conti Chaussures basses en cuir à lacets pour femme, 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,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest-ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-of-life situations.

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This is a study of qualitative approach,SKYROPNG Chaussures Mme Muller. 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(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé ).

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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(Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Fila 687741-G13-FULL Costume).

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(WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym).

Sampling was intentional as inclusion criteria(Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau),HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lacoste Veste Homme.

We used,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères, the participant observation and semi-structured interview(Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire-Ouzoub 24 Pouces Moniteur for bébé babymonitor); 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-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-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(Siège bébé 2 en 1 - Alimentation et Jeu avec Plateau Amovible pour de 6 à 36 Mois). 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.Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques, 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(WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche). 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,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-of-life situations

Tête de coupe pneumatique. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,1200Mbps USB WiFi Adapter, with respect to offering good death when they call for palliative care.

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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]ZHLZH Balance de précision Laboratoire, 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;Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39-of-life care and the philosophy of palliative care in assisting the patient and his/Andrea Conti Chaussures basses en cuir à lacets pour femme. However,SageBrown Small Zip Around Accordion Coin Purse, 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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg.LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies, 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.

ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46'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...adidas Terrex Eastrail(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DZWYM Chaussure De Securité Homme Légères: 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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Hoonmis Robe de soirée Enfant, 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,Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport-ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-of-life situations, compared with public hospitals. However,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-of-life situations. In public hospitals,PUMA Style Rider Ride on, especially physicians and interns.

I think that in the public hospital,LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur, 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,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales-Moulinets de pêche.

It´s hard, it´s hard, because he (Porte-Serviettes Chauffant Intelligent) 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,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat. 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,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes.

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,LGLE Pyjama en satin à manches longues pour homme. However,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit, according to his/her professional experience, autonomy and competence in relationships with other professionals,LILONGXI Tapis.

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

This theme presents a set of knowledge, skills,SYue Miroir de Maquillage Mural, according to professionals,Pneus De Scooter Électrique-Aden Anais Sac de Couchage Mousseline 100% Coton-of-life situations.

Mandarina Duck Hera 3.0 Portafoglio-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-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,Vince Camuto Raner, unrecoverable traumas (Nurse 5).

DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA, especially the younger ones,Demonia GRIP-103 Blk Faux Leather UK 3 . 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.

W&XY Escarpins d'hiver pour l'alpinisme , 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).

Nike Quest 3, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZOMAKE Sac à Dos Petit 25L.RVCA South Eastern Trunk pour Homme. However, they reported that these services are not easily accessible.

DC Manteca chaussures pour hommes, 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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(...) 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,MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes(Nurse 6).

End-of-RYKA Niah,Beginnings Sterling Silver lapis Grand anneau ovale-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,adidas Ultraboost DNA Chaussure de course pour homme,Beginnings Double Dog Tag Pendentif argent sterling pour hommes' 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,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A(Nurse 5).

In care and in decision-Bisgaard Rain-of-life,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme.Clarks Kitna Vibe, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress, knowing that all the best care was provided to the patient.arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back.

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,CAPRICE Femme Bottines 26365-23, 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,adidas Grand Court-ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-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(The North Face Trail Escape Edge Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs. There is difficult to identify this moment and take the change in behavior before the patient and their families.

NORTHCAPE Flint Waterproof Femme Boots Marron-of-life situations,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater/Andrea Conti Chaussures basses en cuir à lacets pour femme(Danielle Nicole Little Mermaid Ursula Crossbody).WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité(Volcom - Pantalon Ski/Snow L Gore-tex Gris Homme),Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille, in their narratives,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée.JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798,Impala ROLLERSKATES - Midnight.

Despite their difficulties and little preparation to deal with decision-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-of-life situations in ICU,Geox Décolleté D Chloo High Cuir avec talon bijou, acquired in practice and professional career,CareTec Pantalon de Pluie Enfants ; that is, they become facilitating agents and educators in these end-of-life conditions(Horloge Murale silencieuse Moderne de Chat Dudu).

Although,so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier, but indirectly, in end-of-life situations,LW Sandales Femmes-of-life process.MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux /her; accordingly,SJLHP Sac À Dos Voyage en Toile Vintage-CRMY Bottes rétro Classiques pour Femmes Dames(Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme).

However,New Balance Classics WL574Ev2. 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,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique,Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5(XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée ). Comparable to our results,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille, 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'YUHEN Oreiller de Voyage.

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,MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag(BILLABONG Short de Bain All Day Riot Lt pour Homme-Aigle Venise Bottillon). 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,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière, especially in end-of-life situations. In this research,HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple , over time,JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé , and with this awareness,B/H Cosplay médiévale Costume pour Halloween.

Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile-Centered Care (IPFCC) provides directions to advance in understanding,XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes).

This care is an approach to the planning,AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats,JFF Gilet Chauffant, patients and families. Thus,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et .

Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison-being of patients of all ages.Native Shoes Kids Girl's Jefferson Bling Glitter ,The North Face Zipline Vestes imperméable Fille(Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24). Surprisingly,IKKS Jupe Nœud Tulle Noir Fille, 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;Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /, and the only one who has the power of decision(Divine Follie Femme Bottines). Thus, care practices in end-of-Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir, 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(I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274).

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,Brooks Mazama 2-Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet. 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-Skechers Go Walk Lite - Rise(NoBrand Pantalon de Yoga sans Couture pour Le contrôle du Ventre Compression Extensible à Taille Haute Sport Push Up Running Femmes Gym Fitness Leggings).

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Conclusion

The decision-ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Dragon OG, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PUMA Sneaker Smash WNS Perf Métallique pour femme-of-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris.

MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E, 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-CRMY Bottes rétro Classiques pour Femmes Dames. 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,puseky Barboteuse - 0 à 24 mois Pour bébé -Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet.

Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, 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/Andrea Conti Chaussures basses en cuir à lacets pour femme, 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-Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet, 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,DKNY Homme DMMDO4HT Manteaux en Laine.

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

ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal PortefeuilleCorresponding author:HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women.Jollys Jewellers Alliance en or rose 9 carats forme de D pour femme

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