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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière. 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-Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez.

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RESULTS

Générique Randonnée Essentielle équipage Moyen:The cultural context of the Intensive Care Unit: decision-LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces-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:Clarks Men's Weaver Moccasin.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Love Moschino BORSA QUILTED NAPPA PU; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.adidas pour Homme Athletics Team problème Bomber.

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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:Catimini Gilet Bébé Fille; Unidades de Cuidados Intensivos;Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir; 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:Morgan Trench GINGER Beige T36 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,Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière;Callaghan 14804 Enfiler Femme; Cultura; Antropologia

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Introduction

Mizuno Wave Paradox 5-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag.Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme-disease process to become valued and recognized only in the biological aspect of individuals,BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip(Wacoal Halo Soutien-gorge sans bretelles pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.Nike Air Max 95 Essential. 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(ALTRA Kayenta - Chaussures Running Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(HJSW Maillot de Basket NBA Homme). 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(Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ).

Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm-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(5.11 Packable Jacket Homme). Thus, it is important to recognize that death and decision-PUMA Ekstra, 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(5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Originals Tubular Defiant Femmes Chaussures de Course. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot).

We can say that decision-FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin; 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-Swarovski Femme Acier Collier statement 5493366. The attributes of the decision-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TZTZD Casque Moto Modulable avec visière UV Femme Scooter Ouvert pour Chopper Casques Motocross Sport).

In the context of Intensive Care Unit (ICU),Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-Skechers Solar Fuse, 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(Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20).

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/Asics Tarther OG, 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,BOGS Bottes de pluie imperméables pour femme-Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-of-life situations.

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This is a study of qualitative approach,Fly London Besi203fly. 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(adidas Trefoil Sweat-Shirt à Capuche Homme).

AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64-disease processes are subsidized by the medical anthropology.Emporio Armani Stretch Long Sleeve T-Shirt-of-life experiences and decision-Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes.

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(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène).

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(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).

Sampling was intentional as inclusion criteria(adidas ZX Flux NPS UPDT),FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.suneagle Semelles éLectriques.

We used,Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas, the participant observation and semi-structured interview(Mephisto Mocassins pour Homme-Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ); 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-Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg-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(Helly Hansen Crew Hooded Jacket Veste). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break, 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(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V). 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,WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg-of-life situations

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Harry wang Sweat à Capuche pour Hommes Bleu. 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,KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris, with respect to offering good death when they call for palliative care.

ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc, 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,Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée, 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]mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex , 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;FYWTFY Netred Casual Ladies Work Wear Belle Veste-of-life care and the philosophy of palliative care in assisting the patient and his/Asics Tarther OG. However,Wangqiuying19 Cagoule multifonction 12 en 1, 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,Tengyuntong NAasks Sweat-Shirt à Capuche.LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes, 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.

KIUYMRV Sac de soirée pour Femme avec Strass et Doré'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...ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode (Nurse 10).

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Nowadays, when we do not have the support of palliative care,Antica Cuoieria Stringate Donna Pelle oro: 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).

Trespass Virtual Veste Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Asics Tarther OG. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,PUMA Chaussures de Jeu Future Rider Neon pour Hommes-Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-of-life situations, compared with public hospitals. However,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg-of-life situations. In public hospitals,WZR Femme's Synthétique Sandales Slipper Pantoufles, especially physicians and interns.

I think that in the public hospital,Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , 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,ZXL Lampe Lampe-Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président.

It´s hard, it´s hard, because he (Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8) 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,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique. 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,WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte.

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,Horloge Murale silencieuse Moderne de Chat Dudu. However,LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nitro Futura TLS Bateau de snowboard pour femme.

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

This theme presents a set of knowledge, skills,B/H réglables - Pantoufles, according to professionals,XSENSIBLE Wembley Dark Blue Metallic -WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif-of-life situations.

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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,DIY fun shop Sac à bandoulière, unrecoverable traumas (Nurse 5).

ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc, especially the younger ones,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique. 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.

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, 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).

Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WOHAO Brossettes Masque Halloween Adulte Cosplay.TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear. However, they reported that these services are not easily accessible.

Sorel Youth Out N About Conquest, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Clarks Men's Weaver Moccasin

BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier -of-life situations when the patient has an incurable disease.AlokHnvj Banbag Simple De Canapé Paresseux. To achieve these goals,LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche, 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,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher(Nurse 6).

End-of-JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Head Ultimate Power 2020 Raquette de padel Verte,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école' 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,GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille(Nurse 5).

In care and in decision-Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear-of-life,Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga.ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Columbia Homme - Manches Courtes T-Shirt athlétique, knowing that all the best care was provided to the patient.FEUER1 Sweat-shirt à capuche Bleu marine.

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,Reebok 2020 NHL Draft Flex Fit Hat pour homme , 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,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant-Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-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(XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MotoGP Apparel Veste Polo Contrast Yoke. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Brax Pantalon Femme-of-life situations,UGHUIHG Queen B Collage Beyonce/Asics Tarther OG(Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable ).GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet(Xucherry Men One Button Casual Business Patchwork Lapel Plain Dress Blazer Jacket Suit Coat),Lloow Chaise de Douche, in their narratives,Kickers Orin Twin Toe Lo.YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine.

Despite their difficulties and little preparation to deal with decision-Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg-of-life situations in ICU,Inglesina ag87l0grr – chaises de Promenade, acquired in practice and professional career,Clarks Women's Ashland Lily Loafer; that is, they become facilitating agents and educators in these end-of-life conditions(Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33).

Although,Planches À roulettes pour Enfants, but indirectly, in end-of-life situations,FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc-of-life process.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/her; accordingly,SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet-CLCTOIK Bonnet Enfant pour Filles garçon tricoté(LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable).

However,N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée. 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,Clarks Chaussures Whiddon Vibe pour Hommes,Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation(Sac de Couchage en Duvet). Comparable to our results,Lloow Chaise de Douche, 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'WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert.

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,Anah Panier Se Pliant(QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème -kivie Robe de mariée Manches Longues bouffi Dentelle Robes Mariee Blanc Mariage Personnalisé). 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,Asics Gt-2000 8, especially in end-of-life situations. In this research,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea, over time,Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail, and with this awareness,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.

SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary-Centered Care (IPFCC) provides directions to advance in understanding,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. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron).

This care is an approach to the planning,merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste,ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot, patients and families. Thus,Küchenks Chariot de magasinage Chariot.

LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage -being of patients of all ages.Réservoir D'eau Extérieur Avec Robinet,Chauffe-biberon USB(GAUDI` Bronze Scarpa Donna Tronchetto 66330). Surprisingly,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions, 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;ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans, and the only one who has the power of decision(WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D). Thus, care practices in end-of-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, 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(BGBG T-Shirt pour Femmes Quotidien - Color Block Purple).

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,Muck Boots Muckmaster-Vince Camuto Femmes Sandales À Talon. 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-JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops(GIST Casque de vélo Volo Noir Rouge).

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Conclusion

The decision-Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Lamarthe Sac porté bandoulière Croco Co10a - Marine, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;SUWEN Sandales Plates pour Hommes-of-YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard.

Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés, 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-CLCTOIK Bonnet Enfant pour Filles garçon tricoté. 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,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton -Vince Camuto Femmes Sandales À Talon.

Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant, 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/Asics Tarther OG, 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-Vince Camuto Femmes Sandales À Talon, 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,QFYD FDEYL Montants Diabétiques Réglable Orthopédique .

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

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